Ms. Tran Thi Trang, Director of the Department of Health Insurance, Ministry of Health, exchanging information - Photo: VGP
Ms. Tran Thi Trang, Director of the Department of Health Insurance, Ministry of Health, discussed with the press about information surrounding this content.
Add more medicine to the commune health station
Madam, in this round of changes to the list of drugs covered by the Health Insurance Fund, the drafting agency has proposed 76 new drugs. What 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.
Accordingly, the largest number of drugs proposed for addition this time is the group of drugs for treating cancer diseases, with 28 active ingredients, including chemicals, targeted drugs, immunomodulators and antidotes for patients after radiotherapy.
The second group is supplemented with antifungal, antibacterial and antiparasitic drugs. Currently, the rate of people suffering from these diseases is also increasing and has a great and long-term impact on the lives 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.
In addition, the drafting agency also proposed other drug groups to be updated this time, including: dermatological group and musculoskeletal group.
Many drugs were proposed to be added to commune health stations this time - Photo: VGP/HM
How will these groups of drugs be supplemented for primary health care, that is, health stations, madam?
Ms. Tran Thi Trang: We have always followed the Party and Government 's guidelines in recent times, especially in Directive No. 72, which is to strengthen grassroots healthcare, especially commune health stations. Therefore, this time, about 457 drugs will be brought to the commune to treat patients.
These drugs focus on several disease groups:
First , the group of diseases related to anti-inflammatory and pain relief. The number of these drugs is the largest.
Second, some groups of drugs related to the treatment of infections, cardiovascular drugs, drugs for the treatment of chronic diseases, and chronic disease management at commune health stations.
We are also planning to gradually bring patients to the lower level for 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.
It can be said that the list of drugs covered by health insurance this time covers a wide range of diseases. We hope that we can invest more in primary health care, in lower levels so that they have enough capacity, enough people, enough doctors to diagnose paraclinical diseases, to examine and provide basic treatment for patients. Then, of course, the prescription and use of drugs will be reasonable and timely for patients.
Invented drugs are also proposed to be included in the list of health insurance payments - Photo: VGP/HM
Invented drugs are also covered by health insurance.
In fact, 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 patients. 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 drug list of the health insurance fund must be truly advanced, effective, of high quality and meet the expectations of the people.
Adding medicine to health insurance payment, must the health insurance contribution level be increased?
Madam, regarding the addition of these drugs to the health insurance payment list, how has the Ministry of Health considered the issue of balance and impact on the health insurance fund? Does adding this list to the health insurance payment require increasing the health insurance contribution level?
Ms. Tran Thi Trang: It is true that in order to include more drugs in the list of health insurance payments, the issue of financial resources for payment is very important. Currently, our health insurance contribution rate is still low, so we can only balance revenue and expenditure and the reserve fund.
However, updating the list of drugs covered by health insurance this time, according to our assessment, it is estimated that each year, we will have to increase spending by more than 2,700 billion VND to add new drugs to the list as well as increase the payment rate for some drugs. Thus, it is clear that we must use the reserve fund.
Currently, it is true that 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 level according to the roadmap.
In the process of increasing the health insurance contribution according to the roadmap, we must also calculate to supplement other funding sources. For example, supplementary health insurance, commercial insurance or also consider support from the budget for the poor, near-poor, low-income people, and other social policy subjects.
We also plan to propose a program to support patients with income but still have many difficulties, to reduce the co-payment 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.
In addition, we also have solutions to effectively use and save funds from the health insurance fund, such as reviewing projects to connect paraclinical data, reviewing professional processes, inpatient treatment for patients to increase outpatient treatment, reduce medical costs, reduce inpatient costs, at the same time strengthen professional decentralization, transfer common and basic diseases to commune level; focus on treating serious diseases... then we will reduce ineffective costs. From there, save the budget of the health insurance fund...
From the above comprehensive solutions, we can ensure the balance of revenue and expenditure after 2027. Because we expand drug benefits, then other benefits, we must have the corresponding source to balance the fund and ensure the sustainability of the health insurance fund.
When is the list of additional drugs in health insurance payment expected to be implemented this time, madam?
Ms. Tran Thi Trang: We will strive for the drug list of this draft Circular to officially take effect from the end of the first quarter of 2026. At that time, people will enjoy the update of this drug list.
Thank you!
Hien Minh (performed)
Source: https://baochinhphu.vn/nhung-thay-doi-lon-trong-danh-muc-thuoc-duoc-bhyt-chi-tra-102251128151055132.htm
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