The updating of the list of health insurance drugs is entering the final stages of completion. On the sidelines of the workshop to collect opinions on the new list, Ms. Tran Thi Trang - Director of the Department of Health Insurance (Ministry of Health) said that this adjustment marks a great step to expand the benefits for people participating in health insurance, especially in the group of cancers and chronic diseases with high treatment costs.
76 new drugs, of which nearly 28 are active ingredients in cancer treatment
According to Ms. Trang, the Ministry of Health proposed adding 76 new drugs to the list of drugs covered by the health insurance fund. Of these, the group of cancer drugs accounts for the largest number with nearly 28 active ingredients, including terminal drugs, immunotherapy drugs, chemicals and detox drugs to support post-rhamology. These are all drugs that are very expensive, but the treatment needs of patients are very high, she said.
In addition to cancer, the new list also adds important drug groups such as: Antimicrobial and antibacterial drugs; Parasite treatment drugs; Cardiovascular, hormonal - diabetes drugs; Musculoskeletal and dermatological drugs; Neurological group drugs, which are less drugs invented due to high research costs.
Some groups of diseases such as neurology have a hard time accessing discovered drugs. This update will help patients benefit more" - Director of the Department of Health Insurance emphasized.
457 drugs brought to the commune level - Strategy to increase grassroots capacity
Another highlight is the strong adjustment towards increasing the capacity of the grassroots level. The Ministry of Health plans to bring 457 drugs to commune health stations, in accordance with the spirit of Resolution 72 on strengthening the grassroots health network.
This drug source mainly includes: Anti-inflammatory - pain reliever drugs; Infection treatment drugs; Diabetes and cardiovascular drugs to manage chronic diseases in the community.
Notably, some cancer drugs for gentle care or high safety levels will also be prescribed at the commune level according to the above regulation. Neuro-medicine drugs are also added to support long-term patient treatment in the community.
"The goal is to help people receive treatment at their home, reduce referrals and reduce travel costs, especially for chronic patients," said Ms. Trang.
The Health Insurance Fund plans to increase spending by more than VND 2,700 billion/year, increasing the contribution level is mandatory
The addition of expensive drugs especially cancer drugs and invented drugs inevitably puts great pressure on the health insurance fund.
According to the estimate of the Ministry of Health, the health insurance fund will have to increase spending of more than VND 2,700 billion per year to pay for new drugs and increase the payment rate of some drugs in the current list. Currently, the fund still has a reserve part, but it is only enough for about two more years.
"From 2027 onwards, increasing the health insurance contribution level according to the roadmap is a must to ensure fund balance," said Ms. Trang.
The roadmap for increasing the contribution level will be accompanied by support policies such as: The State will support all or part of the contribution level for the poor, near-poor, policy beneficiaries, children, students and people with average income and below.
Enterprises and workers will be adjusted according to a suitable roadmap.
The Ministry of Health also researched and developed a co-payment support program, helping to reduce the financial burden for patients using high-priced drugs. In addition, solutions for supplementary health insurance and commercial insurance are set out to increase payment resources.
Currently, many drug support programs are helping patients with serious illnesses. In response to concerns that these programs will stop when the new list takes effect, Ms. Trang affirmed:
All support programs approved by the Ministry of Health still accept normal patients. When the new list is issued, many drugs previously eligible for support will be paid by the health insurance fund, ensuring continuous benefits for patients".
In addition, the Ministry of Health is submitting to the Government a pilot resolution to create a synchronous support mechanism, in accordance with Resolution 72 and Directive 52, towards a further goal: to exempt basic hospital fees thanks to contributions from many sources.
The Ministry of Health's updated list of health insurance drugs this time not only significantly increases the rights of patients, especially in the treatment of high- cost diseases such as cancer, but also demonstrates the strategic orientation of the health sector: bringing treatment closer to the people, investing in prevention, spending effectively and fairly in healthcare access.
However, to maintain the system sustainably, adjusting the health insurance contribution level according to the roadmap is inevitable in the coming period.
Early investment strategy in prevention to reduce late treatment costs
The strategy of expanding drugs to the commune level is closely linked to the goal of controlling diseases early and treating more outpatients. According to Ms. Trang, the average cost of inpatient treatment at the upper level is more than 4 million VND/term, while at the commune level it is only about more than 2 million VND. Outpatient treatment at the basic level is only from 300,000500,000 VND.
When the disease is well managed, without serious progression, without late treatment, the cost is significantly reduced. This is the reason we emphasize increasing commune capacity, she explained.
