Proposal to amend the Circular on the list of pharmaceutical drugs, biological products, radioactive substances, and markers covered by health insurance

The Ministry of Health has just issued a draft circular on the list of health insurance drugs, updating 81 new drugs. This helps health insurance participants have better rights in treating diseases. Let's find out more about these changes and their impact on patients.

Attending the meeting on the afternoon of November 18 were representatives of the Departments: Medical Examination and Treatment Management, Pharmaceutical Management, Traditional Medicine Management Department; Departments: Health Insurance, Planning - Finance, and Legal Affairs.

Alternate member of the Party Central Committee, Permanent Deputy Minister of Health , Dr. Vu Manh Ha chaired the conference.

Previously, on November 16, 2024, the Ministry of Health issued Circular No. 37/2024/TT-BYT stipulating principles and criteria for developing, updating, recording information, list structure and payment instructions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants.

The draft Circular promulgating the list of pharmaceutical drugs, biological products, radioactive substances and markers within the scope of benefits for health insurance participants closely follows Circular No. 37 and is based on the scientific and legal basis in Circular No. 20/2022/TT-BYT dated December 31, 2022 of the Ministry of Health.

The Draft Circular and Draft List are based on the principles and criteria for developing and updating the list of active ingredients within the scope of benefits for health insurance participants. This contributes to developing and updating the list of drugs publicly, transparently, regularly and effectively.

Alternate member of the Party Central Committee, Permanent Deputy Minister of Health spoke.

In the list of the draft Circular, continue to count and review 1,037 active ingredients already in Circular 20. Initially, propose to update and add 81 new drugs mainly used to treat cancer, cardiovascular disease, diabetes, hypertension, anti-infective, anti-fungal;

Adjust the scope of drug use, not only by hospital class, basic level but also expand 357 drugs within the scope of Commune Health Stations, primary health facility level; propose to change the payment rate for 47 drugs already in the list; plan to remove from the list 130 drugs with active ingredients that no longer have circulation registration numbers, are not rare drugs, and do not have import licenses.

Speaking on the Draft Circular, representatives of relevant units agreed on the close coordination over the past time in building the outline framework, the legality of the draft list of legal drugs and the list of drugs removed from the list all closely followed the set of evaluation criteria, ensuring the correct procedures in implementing payment for health insurance examination and treatment.

With the Draft List of Drugs, it is necessary to assess the budget impact of drugs, assess safety and continue to recommend that businesses reduce the cost of drug products to include in the payment rate in a way that benefits patients without affecting the Health Insurance Fund. The drafting unit needs to continue to carefully review the provisions of current laws in the Health Insurance Law and the Pharmacy Law for effective application.

Leaders of the Health Insurance Department reported at the meeting.

Concluding the meeting, Permanent Deputy Minister of Health Vu Manh Ha affirmed the early completion and promulgation of the Circular amending and supplementing Circular No. 20/2022/TT-BYT dated December 31, 2022, ensuring more consistency and strictness than Circular No. 37/2024/TT-BYT. The Deputy Minister emphasized the need to encourage medical examination and treatment facilities to develop expertise and techniques; attract human resources; create conditions for medical staff to improve their capacity, especially at the grassroots level, in accordance with the technical and professional classification according to the Law on Medical Examination and Treatment.

Permanent Deputy Minister Vu Manh Ha assigned the Health Insurance Department to take the lead, continue to coordinate with relevant units to research, review and supplement drugs that require long-term treatment and high costs; at the same time, carefully study the content related to "medical gas" when included in the Draft, ensuring full compliance with legal regulations.

In the spirit of fairness and science, the Deputy Minister suggested considering adjusting the payment rates and conditions in a reasonable and appropriate manner; creating a balance in drug access for the people; meeting the prescribed criteria and achieving high consensus. In particular, it is necessary to maximize decentralization and delegation of authority to the commune level; reduce the co-payment level of patients, while ensuring the economical and effective use of the Health Insurance Fund.

To meet the set schedule, the Deputy Minister requested units to focus on implementation, first of all, widely collect opinions from relevant agencies and localities, fully synthesize and submit to the Ministry's leaders for consideration and promulgation.

Source: https://suckhoedoisong.vn/de-xuat-sua-doi-thong-tu-danh-muc-thuoc-hoa-duoc-sinh-pham-chat-phong-xa-danh-dau-do-bhyt-chi-tra-169251119093425142.htm