Patients have more opportunities to access new drugs

Using Health Insurance Fund effectively

The conference on evaluating medical technology in building health insurance benefits was held by the Ministry of Health and the Vietnam Medical Association today, December 13, in Hanoi.

Australian experts share experience in medical technology assessment, cost-effectiveness, helping patients have more access to new drugs

At the conference, Professor, Dr. Tran Van Thuan, Deputy Minister of Health, said that in many countries around the world, health technology assessment has been considered an important tool for the process of setting priorities and planning health policies, especially in building health insurance benefit packages.

In Vietnam, in the context of limited resources for health care, while people's health care needs are increasing, requiring the Health Insurance Fund to cover more health services more effectively, medical technology assessment has become a tool that needs to be developed and applied in the process of planning health policies and health insurance policies.

In recent years, the Ministry of Health has been coordinating with relevant agencies and units to develop policies that apply evidence on medical technology assessment such as price negotiations with suppliers, selecting medical interventions to build a list of health insurance drugs.

Representative of the Department of Health Insurance (Ministry of Health), Ms. Vu Nu Anh added that in Vietnam, the context of limited resources for health care requires the Health Insurance Fund to cover health services more effectively. Assessing health technology will help to know the reasonableness of total health spending.

Evaluating medical technology helps to evaluate spending efficiency and find solutions to reduce out-of-pocket spending. Currently, people's out-of-pocket spending on healthcare still accounts for about 43 - 45%, which is a financial burden for patients.

For equitable access to health services, the World Health Organization recommends that this ratio should not exceed 25%.

Evaluation of medical technology, drug effectiveness, and medical services helps to pay for medical examination and treatment effectively, and patients have access to new drugs.

Drug costs account for 35% of the Health Insurance Fund's payments.

According to the Department of Health Insurance, medical technology assessment is an assessment of the effectiveness of the medical service portfolio, including payment for medicine, because this is a large expense for medical examination and treatment. Currently, of the total expenditure from the Health Insurance Fund, about 35% is spent on medicine. Previously, the cost for medicine was more than 60%.

In fact, although the rate of spending on drugs has decreased, the total spending on drugs has increased, nearly 5 billion USD, of which 1.8 billion USD is spent on drugs from the Health Insurance Fund/year.

Sharing experiences in assessing medical technology focusing on assessing the cost-effectiveness of high-cost drugs in Thailand and some other countries, a representative of the Department of Health Insurance said that from assessments of the effectiveness of drugs and medical services, competent authorities have made decisions to negotiate prices, include new drugs in the health insurance list, and increase people's access to new drugs. Costs for assessing medical technology come from sources from the Ministry of Health and support funds.

Controlling expenditures of the Health Insurance Fund needs to be in the direction of increasing revenue and reducing expenditures, through the application of control measures such as focusing on innovating payment methods (capitation, payment by case).

After more than 30 years, in Vietnam, health insurance covers more than 92% of the population with more than 90 million people having health insurance cards.

Every 3 years, the Ministry of Health updates and supplements the list of new drugs covered by the Health Insurance Fund. The assessment of medical technology will help to use drugs effectively, including updating new drugs that patients are covered by the Health Insurance Fund.

Professor Thuan said that along with adding drugs to the list of drugs covered by the Health Insurance Fund and expanding benefits for health insurance patients, the Ministry of Health is implementing solutions to ensure fund balance such as: negotiating prices with copyrighted drugs, drug support programs for cancer patients and proposing to implement additional health insurance packages.

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