Proposal for health insurance to cover many cancer and cardiovascular drugs

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

Update the list of drugs, pharmaceuticals... covered by health insurance

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

Mr. Vu Manh Ha, Permanent Deputy Minister of Health, said that in recent years, medicine has always been an important component and accounted for a large proportion of the total cost of medical examination and treatment under health insurance. Ensuring medicine benefits for health insurance participants plays an important role in health insurance policy and the policy of protecting, caring for and improving people's health.

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

Therefore, choosing to use and pay for health insurance for medicine in a reasonable way needs attention to contribute to reducing treatment costs, effectively using health insurance funds and reducing people's out-of-pocket expenses.

Currently, the payment of drug costs for health insurance participants is implemented according to the list and regulations of Circular No. 20/2022. The drug list includes 1,037 active ingredients, pharmaceutical drugs and biological products divided into 27 large groups and 59 radioactive drugs and tracers. Over the years, this list has not been updated in a timely manner.

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

Accordingly, the drug list has been reviewed, updated with new drugs; some conditions and payment rates have been revised and drugs that are no longer in circulation and do not meet safety and effectiveness criteria have been considered for removal from the list.

In addition, according to Deputy Minister Ha, this update, revision and supplement also focuses on expanding the drug list for commune health stations, increasing full and convenient access to health care for people right at the initial level.

Will the health insurance premium increase ?

Ms. Tran Thi Trang, Director of the Department of Health Insurance, Ministry of Health, added that 81 new drugs have been proposed to be included in the list. Of these, 76 drugs (including many drugs for cancer and cardiovascular treatment) meet the criteria for inclusion in the health insurance list, ensuring that the proposed drugs have good treatment effectiveness and are safe; some remaining drugs are being reviewed and considered.

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

The Ministry of Health estimates that in 5 years, the health insurance fund will increase spending by about 12,245 billion VND.

In addition, there are 14 proposals to reduce prices for 14 drugs with a commitment to reduce drug prices from 6.5% to 60.77% to have a better payment rate, reduce costs for patients and contribute to the balanced and effective use of the health insurance fund.

Some drugs are also proposed to change conditions, payment rates; removed from the list.

“According to the Ministry of Health’s calculations, the health insurance fund can cover medical examination and treatment activities for the next 2 years. By 2027, the health insurance contribution rate will have to be increased to balance the fund and have a source of payment for medical examination and treatment. When increasing the payment rate and adding more drugs to the list, we will also need to increase the health insurance contribution rate to cover the costs.

However, we also calculate that there needs to be a roadmap to increase the health insurance premium appropriately, close to the economic and social 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