The biggest revision of the list of health insurance drugs in 8 years with the addition of 76 drugs, including 28 cancer drugs and bringing 457 drugs to the commune level. On the sidelines of the workshop to collect opinions on the new list of drugs, Ms. Tran Thi Trang, Director of the Department of Health Insurance ( Ministry of Health ) discussed with the press about the information surrounding this content.
Expanding the list of drugs covered by health insurance at primary health care facilities
Reporter : Madam, in this round of changes to the list of drugs paid for by the Health Insurance Fund, the drafting agency has proposed 76 new drugs. So, which treatment groups do these drugs focus on?
Ms. Tran Thi Trang : This is the update of the list of drugs paid by the Health Insurance Fund with the largest number of new drugs added to date. Currently, we are estimating about 81 drugs proposed to be added to the list. Of these, 76 drugs have met the criteria, and some of the remaining drugs are still being reviewed and considered.
The largest number of proposed additional drugs this time is the group of drugs to treat cancer diseases, with 28 active ingredients, including chemicals, targeted drugs, immunomodulators and anti-toxic drugs for patients after radiotherapy.
The second group that was added was antifungal, antibacterial, and antiparasitic drugs. This is a group of drugs that currently has an increasing rate of people suffering from diseases, which have a large and long-term impact on the survival of patients.
Some other drug groups are also of great interest to be included in this list such as cardiovascular drugs, endocrine drugs, and diabetes drugs.
Particularly for the group of psychotropic drugs, over the years, the number of drugs invented in this group is very small, the cost of drugs is high, patients' access to drugs is also difficult, businesses have little investment, while this group of patients is a highly vulnerable group and has very low ability to pay. Therefore, in this update, the drafting agency also paid attention to including some drugs in this group.
Some other groups of drugs, such as dermatology and musculoskeletal, are also proposed by the drafting agency to be added to this drug list.
Reporter : It is known that this update, revision and addition also focuses on expanding the drug list for commune health stations. Could you please provide more specific information about this direction?
Ms. Tran Thi Trang : We have always followed the Party and Government 's directives in recent times, especially Resolution 72, to strengthen the capacity of grassroots health care and commune health stations. Therefore, this time, about 457 medicines will be brought to the commune to treat patients.
The drugs mainly focus on anti-inflammatory-pain relievers, anti-infective drugs, cardiovascular drugs, and diabetes drugs to support chronic disease management.
We are also planning to gradually bring patients to lower-level palliative care for cancer. Therefore, some drugs in the cancer group will be brought to the commune health station for palliative care for patients.
At the same time, we are also planning to bring some drugs related to detoxification to the commune to be prescribed by the higher level to patients. These drugs often have few side effects or can be safely used as outpatients and are also brought to the grassroots health care.
Some other groups of drugs such as neuropsychiatric drugs are also brought to the commune to manage, distribute and serve patients right at the commune.
We have a strategy to gradually bring patients to the lower level for palliative treatment for cancer. Therefore, some drugs in the cancer group will be brought to the commune health station for palliative care for patients.
Ms. Tran Thi Trang - Director of Health Insurance Department (Ministry of Health)
It can be said that the list of drugs covered by health insurance this time covers many diseases. The goal is to help people receive treatment at their place of residence, reducing the burden of referrals and travel costs.
We expect that the primary and lower level health care will continue to be invested in human resources and professional capacity, with enough doctors to diagnose, examine and treat the people. When this system is strengthened, the prescription and prescription of drugs will be reasonable, timely and better meet the needs of patients.
Invented drugs are also covered by health insurance.
Reporter : There are immunotherapy drugs that have very high treatment costs, about 5 million to 60 million VND/dose. Is this the highest payment from the Health Insurance Fund for patients, madam?
Ms. Tran Thi Trang : It can be said that the drugs included in the list of health insurance payments this time include many new drugs and innovative drugs. Especially in the group of cancer diseases, which have high treatment costs. Because they are innovative drugs, the price is naturally high. Therefore, the benefits for patients will be greatly benefited.
This of course also affects the budget of the Health Insurance Fund, but we realize that it is really necessary for the sick. We always ensure that people enjoy the best benefits, this is the focus of the social security policy of the Party and the State.
Therefore, we have also considered and reviewed very carefully to include in the list of drugs, including invented drugs and drugs with high costs, so that the list of drugs of the Health Insurance Fund must be truly advanced, effective, of high quality and meet people's expectations.
We have also carefully considered and reviewed to include in the list of drugs, including patented drugs and high-cost drugs.
Ms. Tran Thi Trang - Director of Health Insurance Department (Ministry of Health)
Reporter : Does drug supplementation, especially cancer drugs and innovative drugs, have an impact on the Health Insurance Fund, madam?
Ms. Tran Thi Trang : According to estimates, each year the Health Insurance Fund will have to increase spending by more than 2,700 billion VND for new drugs and increase the payment rate of some drugs in the list.
Currently, we still have a reserve fund from the Health Insurance Fund, however, this source is only enough for about the next 2 years. Therefore, we believe that there will have to be solutions to expand the source of the Health Insurance Fund.
This time we are assessing very carefully the budget impact of the Health Insurance Fund. Accordingly, from 2027 onwards, we will have to consider increasing the health insurance contribution rate according to the roadmap.
Along with that, we must consider additional sources such as supplementary health insurance, commercial insurance and budget support for the poor, near-poor, low-income people and vulnerable groups.
We also plan to propose a program to support patients who are still in difficulty, to reduce the co-payments for patients. At the same time, we must also gradually expand the revenue of the Health Insurance Fund from other activities such as tax revenue on cigarettes. Currently, we are proposing to the National Assembly to have a disease prevention fund from this revenue source.
Along with increasing revenue, solutions for effective use and cost savings from the Health Insurance Fund are also focused on, such as reviewing projects for connecting paraclinical data; reviewing professional processes, reviewing treatments towards increasing outpatient treatment, reducing inpatient costs; strengthening professional decentralization, transferring common and basic diseases to commune levels, focusing on treating serious diseases at higher levels... Thereby, reducing ineffective costs, contributing to saving the budget of the Health Insurance Fund.
From these comprehensive solutions, it is expected that after 2027, the Health Insurance Fund will be able to ensure revenue-expenditure balance.
Reporter: So when can people benefit from the new drug list, madam?
Ms. Tran Thi Trang : The Ministry of Health strives for the drug list of this Circular to officially take effect from the end of the first quarter of 2026. At that time, people will benefit from this updated drug list.
Reporter: Thank you very much!
Source: https://nhandan.vn/de-xuat-bo-sung-danh-muc-thuoc-bao-hiem-y-te-mo-rong-quyen-loi-cho-benh-nhan-post926843.html
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