From 2025, the regulation on dividing drug lists by hospital class will be abolished.

The Ministry of Health has just issued Circular 37, amending and supplementing new regulations to alleviate difficulties for hospitals and facilitate convenience for patients. The new circular will take effect from January 1, 2025.

Enhancing patients' access to treatment drugs (illustrative image).

According to Ms. Vu Nu Anh, Deputy Head of the Health Insurance Department (Ministry of Health ), in recent years, medicine has always been an important component and has consistently accounted for a large proportion of the total cost of medical examination and treatment under health insurance.

Currently, the issuance of the List and regulations on health insurance payment for drugs is being carried out according to Circular No. 20/2022/TT-BYT dated December 31, 2022, issued by the Minister of Health, which promulgates the list and rates, and conditions for payment of chemical drugs, biological products, radioactive drugs, and markers within the scope of benefits for health insurance participants.

Ms. Nu Anh stated that, after nearly two years of implementation, Circular No. 20 has revealed some problematic issues, requiring amendments, additions, and adjustments to suit the actual situation.

The Ministry of Health has just issued Circular 37 to address these shortcomings, and from January 1, 2025, medical examination and treatment facilities nationwide will comply with this new circular.

Accordingly, previously, medicines used and reimbursed by health insurance at medical facilities were categorized according to hospital classification: Special-class, Class I, Class II, Class III, and Class IV hospitals; and technical specialization levels including: Central, provincial, district, and commune levels.

According to the new circular, the list of drugs is not divided according to hospital category. Therefore, medical examination and treatment facilities can use all drugs on the list, in accordance with their scope of professional activities, diagnostic and treatment guidelines, regardless of hospital category or technical expertise level.

This encourages healthcare facilities to develop their expertise and techniques; attracts human resources and promotes the development of healthcare staff's capabilities, especially creating favorable conditions for the development of primary healthcare by ensuring fairness in access to and reimbursement of medicines under health insurance.

Not categorizing medications by hospital type also helps to limit patients' preference for seeking medical examination and treatment at high-tech medical facilities, thereby reducing overcrowding at some high-tech medical facilities.

The new circular also adds new regulations on drug payment guidelines, such as regulations on payment for drugs at commune health stations, contributing to increased access to drugs for patients with chronic diseases when managed and treated at health stations, while creating a financial mechanism to encourage the development and improvement of professional capacity of staff at commune health stations.

Or, regulations should be established to cover the payment for medications used to treat chronic diseases when patients are undergoing inpatient treatment for other conditions, in order to ensure that health insurance participants have continuous access to and benefit from health insurance coverage for these medications.

Additionally, there are provisions for drug reimbursement in special cases, contributing to flexibility in exceptional situations such as natural disasters, war, and catastrophes.

According to the head of the Health Insurance Department, these new regulations will help to add cases covered by the Health Insurance Fund, thereby increasing access to medication, providing flexibility in payment guidance for patients, and enabling medical facilities to reimburse medication costs that were previously not covered due to a lack of specific guidelines.

This contributes to ensuring the rights of health insurance participants, while also creating a financial mechanism to promote the development of medical examination and treatment facilities.

Source: https://www.baogiaothong.vn/tu-2025-bo-quy-dinh-phan-chia-danh-muc-thuoc-theo-hang-benh-vien-192241119160002018.htm