Sending opinions to the 9th Session of the 15th National Assembly, Dong Nai voters proposed to consider studying and expanding the list of medical examination and treatment services covered by 100% health insurance, and to consider increasing the insurance payment level for other medical examination and treatment services. At the same time, review, update, adjust, and expand the list of medical treatment drugs covered by health insurance to ensure the rights of the people. This is also a recommendation of Ninh Binh voters.
'The list of drugs is relatively complete, comprehensive and extensive compared to the health insurance premium'
Responding to these recommendations, Minister of Health Dao Hong Lan in an official dispatch dated July 14 assessed that the list of technical services paid for by the health insurance fund for health insurance participants is "relatively complete, meeting the basic treatment needs" of the people with more than 9,000 technical services.
"Most technical services are being implemented at medical examination and treatment facilities covered by the Health Insurance Fund," said the Minister of Health.
According to the provisions of the Law on Health Insurance, subjects can have the health insurance fund pay 80%, 95% or 100% of the cost of medical examination and treatment under health insurance.
"The adjustment of the scope of benefits and the level of enjoyment of health insurance participants is based on the contribution level and the payment capacity of the health insurance fund," the head of the health sector affirmed. She also said that Vietnam is considered one of the few countries with a relatively complete, comprehensive and expanded drug list compared to the health insurance premium.
In fact, in the expenditure structure of the Health Insurance Fund, the proportion of expenditure on drugs still accounts for the highest, more than 31%. The list of modern medicines issued by the Ministry of Health in 2022 includes 1,037 active ingredients/chemical drugs and biological products divided into 27 large groups and 59 radioactive drugs and markers; of which 76 active ingredients/chemical drugs and biological products belong to the group of drugs for cancer treatment and immunomodulation.
The selection of finished drugs covered by the health insurance fund at medical examination and treatment facilities is not limited by treatment indications, treatment specialties, acute or chronic diseases. Minister Dao Hong Lan said that in reality, the number of commercial drugs covered by the health insurance fund will be much larger than the above list. Because the list of health insurance drugs in Vietnam is listed in the form of active ingredient/ingredient names, without content, dosage form and trade name.
The list of traditional medicines and herbal medicines is not classified by hospital class, so all primary health care facilities can use the entire list (except for a few medicines with payment conditions).
Urgently add new drugs
According to a report from the IQVIA MIDAS Pharmaceutical Research Organization in 2022, of the 460 new drugs launched for the first time globally in the period 2012-2021, only 9% (equivalent to 42 drugs) are available in Vietnam. Meanwhile, the Asia-Pacific region averages 20%, Japan 51%, South Korea 33%, and some countries such as Thailand, China, Singapore, and Malaysia 22-27%.
Of the 42 new drugs available in Vietnam, patients can only access 27% of them through the List of drugs covered by health insurance funds at public health facilities.
In the report evaluating 15 years of implementing the Law on Health Insurance, the Ministry of Health said that every two years, this agency will review, revise and supplement the Drug List.
Health insurance payments have only been adjusted four times in the past 15 years, in 2012, 2014, 2018 and 2022. On average, the new drug list is added once every 3-4 years.
Because the list of health insurance drugs is not updated regularly and continuously, many patients have to use 1-2 types of health insurance drugs for many years, leading to some side effects. Even though doctors know that the drugs have side effects, they still have to prescribe them to patients because if they prescribe drugs that are not on the health insurance list, the patient will take them "appropriately" but have to pay for them out of pocket. Financial conditions do not allow any patient to buy outside drugs, in fact, there are patients who give up treatment because outside drugs are too expensive.
Affirming that the Ministry of Health is urgently reviewing, revising and updating the Circular promulgating the list of drugs to add to the list new drugs with high treatment effectiveness and remove drugs that are no longer suitable from the list, Minister Dao Hong Lan said that the addition "needs to be carefully considered to ensure the payment capacity of the Health Insurance Fund".
NH (according to Vietnamnet)Source: https://baohaiphongplus.vn/khan-truong-ra-soat-bo-sung-danh-muc-thuoc-bao-hiem-y-te-moi-416411.html
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