Proposal for health insurance to cover more cancer and cardiovascular drugs.

(Dan Tri Newspaper) - The Ministry of Health has proposed adding 76 new drugs to the list of drugs covered by health insurance, including 28 cancer treatment drugs (22 targeted drugs).

Updated list of drugs, pharmaceuticals, etc., covered by health insurance.

On November 28th, the Ministry of Health organized a workshop to solicit feedback on the draft Circular promulgating the List of chemical drugs, biological products, radioactive drugs, markers, and the payment of medical gases used in medical examination and treatment within the scope of coverage for health insurance participants.

Mr. Vu Manh Ha, Permanent Deputy Minister of Health, stated that in recent years, medicine has always been a crucial component and accounts for a large proportion of the total cost of medical examination and treatment under health insurance. Ensuring the right to medicine for health insurance participants plays a vital role in health insurance policy and in the policy of protecting, caring for, and improving the health of the people.

Mr. Vu Manh Ha, Permanent Deputy Minister of Health, speaks at the workshop (Photo: Tran Minh).

Therefore, the rational selection, use, and payment of health insurance for medications should be considered to help reduce treatment costs, utilize health insurance funds effectively, and reduce out-of-pocket expenses for the people.

Currently, the reimbursement of drug costs for health insurance participants is based on the list and regulations of Circular No. 20/2022. The list includes 1,037 active ingredients, chemical drugs, and biological products divided into 27 major groups, and 59 radioactive drugs and markers. For many years, this list has hardly been updated in a timely manner.

To meet the treatment needs of the people and medical facilities, from 2023 to the present, the Ministry of Health has chaired and coordinated with relevant agencies and units to review, update, and draft a list of chemical drugs to replace the list of drugs in Circular No. 20/2022/TT-BYT.

Accordingly, the drug list has been reviewed and updated with new drugs; some conditions and payment rates have been modified, and consideration has been given to removing drugs that are no longer in circulation or do not meet safety and efficacy criteria from the list.

In addition, according to Deputy Minister Ha, this update and revision also focuses on expanding the list of medicines for commune health stations, enhancing access to comprehensive and convenient healthcare for people right at the primary level.

Will health insurance contributions increase ?

Ms. Tran Thi Trang, Director of the Health Insurance Department, Ministry of Health, added that 81 new drugs have been proposed for inclusion in the list. Of these, 76 drugs (including many drugs for treating cancer and cardiovascular diseases) meet the criteria for inclusion in the health insurance list, ensuring that the proposed drugs have good treatment efficacy and safety; the remaining drugs are still under review and consideration.

Ms. Tran Thi Trang, Director of the Health Insurance Department, Ministry of Health (Photo: Tran Minh).

The Ministry of Health estimates that the health insurance fund will see an increase in spending of approximately 12,245 billion VND over the next five years.

In addition, there are 14 proposals for price reductions for 14 drugs, with commitments to reduce drug prices by 6.5% to 60.77% to achieve better reimbursement rates, reduce costs for patients, and contribute to the balanced and efficient use of the health insurance fund.

Some drugs have also been proposed for changes to their payment conditions and rates, or removal from the list.

"According to calculations by the Ministry of Health, the health insurance fund can cover medical examination and treatment activities for the next two years. By 2027, the health insurance contribution rate will have to be increased to balance the fund and have a source of funds for medical examination and treatment. When the reimbursement rate increases and more drugs are added to the list, we will also need to increase the health insurance contribution rate to cover these costs."

However, we also consider the need for a suitable roadmap to increase health insurance contributions, closely aligned with the socio- economic situation, ensuring fund balance and expanding benefits for the people,” Ms. Trang shared.

Source: https://dantri.com.vn/suc-khoe/de-xuat-bao-hiem-y-te-chi-tra-nhieu-thuoc-ung-thu-tim-mach-20251128132236680.htm