For chronic patients, taking medication every two months is a win-win situation.

Patients receive medication covered by health insurance at District 1 Hospital, Ho Chi Minh City - Photo: DUYEN PHAN

This proposal has been supported by public opinion because it offers benefits to both sides: reducing the burden on the healthcare system and making it convenient for people (especially those in rural areas).

Tuổi Trẻ newspaper quotes the opinions of patients and the medical sector on this issue:

- Mr. NGUYEN DUC HOA (Deputy Director of Vietnam Social Insurance):

The proposal is based on expert opinion.

Mr. Nguyen Duc Hoa

This proposal is based on expert opinion, suggesting that for patients with stable chronic diseases, changing medication monthly is unnecessary. During the COVID-19 pandemic, the Ministry of Health also implemented a quarterly prescription system for certain chronic diseases without complications.

Therefore, Vietnam Social Security proposes prescribing outpatient medication for this group of patients for a minimum of 60 days and a maximum of 90 days, instead of the current 30 days.

Extending the prescription timeframe benefits both patients and hospitals. Patients can delay follow-up visits, saving them travel time, effort, and costs. Additionally, it reduces the burden on hospitals in providing health insurance coverage for patients with stable chronic conditions.

Since 2023, we have twice submitted written proposals to the Minister of Health regarding the time frame for prescribing medication. I hope the Ministry of Health will study the proposal and implement it as soon as possible.

- Mr. NVD (55 years old, Ho Chi Minh City, has had diabetes for many years):

Reduce the burden on patients.

I've been ill for many years and have received stable treatment, but I have to take time off work every month to go to the hospital for check-ups and prescriptions. Meanwhile, most of the medications prescribed monthly are the same, and in some cases, I need to have tests done again every 3-6 months before the medication is adjusted.

I suggest that patients with chronic illnesses should be given medication for 60 days, as this would help reduce their burden.

- Mr. PHAM VAN NHAN (65 years old, Ninh Binh province):

Flexible options for patients who are unable to travel long distances.

I was diagnosed with diabetes and hypertension about three years ago, and I have to go to the hospital every month for check-ups and prescriptions. However, because I'm elderly and my children and grandchildren don't live nearby, I often have to walk and then take a bus to the provincial hospital, which is 40km from my house, to get my prescription.

The hospital is crowded with patients, making it very difficult for elderly and frail patients like us. I really hope that the time spent prescribing medication can be extended to ease the burden on patients.

- Mr. NGUYEN THANH TAM (Director of District 1 Hospital, Ho Chi Minh City):

Adjustments should be considered depending on the specific chronic disease.

Mr. Nguyen Thanh Tam

Depending on the type of chronic disease, doctors may have flexibility in adjusting the prescription duration for patients. For newly diagnosed patients, the maximum prescription duration should be 30 days to allow doctors to assess the situation, conduct further tests, etc.

For patients with long-term, stable conditions, the prescription period may be extended beyond 30 days, especially in cases such as: living far from the hospital, traveling, or being unable to attend regular follow-up appointments.

However, some chronic diseases have many risk factors that can easily lead to complications and worsening conditions, so one should not be complacent and should go to the hospital for doctors to reassess the situation.

For example, with some chronic diseases like high blood lipid levels, follow-up appointments should be every 1-2 weeks or monthly for testing, assessment, and adjustment of medication dosage by doctors.

- Dr. Tran Thanh Tung (Deputy Head of the Department of Pharmacology, Hanoi Medical University):

It can be done soon.

Dr. Tran Thanh Tung

Chronic diseases require long-term medication. After an initial prescription phase of 15-30 days to find the appropriate medication and dosage, the doctor will reassess the patient and may prescribe medication for 60 days.

Implementing this will save healthcare manpower, reduce the burden on hospitals, and also save time and costs for people with chronic diseases. The Ministry of Health should soon agree to implement the regulation on prescriptions for chronic diseases for 60 days.

- Ms. TRAN THI OANH (Deputy Director of Duc Giang General Hospital, Hanoi):

Hospitals are experiencing revenue loss, but they need to look further ahead.

Ms. Tran Thi Oanh

I support prescribing medication every two months for patients with stable chronic conditions, instead of the current monthly schedule. The proposed three-monthly schedule is too long; I think it's not advisable.

For patients with chronic diseases such as hypertension and diabetes, doctors will decide whether to prescribe medication every two months or once a month, depending on the individual patient's condition. The prescription must ensure the patient's health and convenience.

Many hospitals are concerned that increasing medication dispensing to once every two months will reduce revenue from patient visits. I believe this reduction in revenue will not significantly impact hospitals; in fact, looking further ahead, hospitals will benefit from better patient management and increased credibility with patients.

If medication is prescribed every two months, it means the doctor's visits will be reduced by half, allowing the doctor more time for consultations, thorough screenings, and interaction with patients.

In addition, while revenue from outpatient visits may decrease, this money remains within the health insurance fund and can be used for other purposes. Hospitals can utilize the fund more effectively, such as conducting more in-depth tests for patients with advanced conditions instead of routine monthly tests for disease management.

- Mr. NGUYEN TRONG KHOA (Deputy Director of the Department of Medical Examination and Treatment Management - Ministry of Health):

Careful consideration is needed.

Mr. Nguyen Trong Khoa

During the COVID-19 pandemic, due to social distancing measures and disease prevention efforts, the Ministry of Health implemented a quarterly outpatient medication dispensing schedule. However, a complete adjustment requires careful consideration of the benefits and risks. The benefits include reduced travel time for the public and a reduced burden on hospitals.

Prolonging the prescription period can also lead to the risk of patients not receiving follow-up examinations for extended periods, resulting in a lack of close monitoring of their condition and potentially affecting treatment. We are considering researching this proposal and will make adjustments to the regulations and circulars guiding the prescription timeframe.

Duration of prescription of chronic disease treatment drugs in various countries

In most countries around the world, the prescribed duration of medication for chronic diseases ranges from 28 to 30 days. However, in recent years, an increasing number of countries have considered extending this duration.

In Australia, in April 2023, the relevant authorities approved prescriptions for up to 60 days for 320 different medications. These drugs are primarily used to treat heart disease, high blood pressure, obesity, and other conditions.

With this change, the Australian government estimates that each patient will save up to AUD 180 per year (VND 2,900,000). Over four years, the country could save up to AUD 1.6 billion.

In Thailand, since 2016, Phramongkutklao Military Hospital has been conducting a pilot program where all patients are prescribed a 3-month (90-day) course of medication.

A study published in May 2023 by a team of scientists at this hospital and Chulalongkorn University showed that giving all patients a 90-day course of medication contributed to an increase in patient adherence to prescriptions.

In the UK, the Department of Health does not set any rigid limits but only regulates the duration of each prescription, "balancing patient convenience and clinical condition, cost savings and patient safety."

Source: https://tuoitre.vn/nguoi-benh-man-tinh-lay-thuoc-2-thang-lan-co-phai-loi-doi-duong-20240420232047824.htm