Thuốc điều trị ung thư dẫn đầu danh sách đề xuất bổ sung vào danh mục BHYT chi trả

The Health Insurance Department of the Ministry of Health is developing an updated list of pharmaceutical and biological drugs covered by health insurance. It is expected to add 84 new drugs, including 30 cancer treatment drugs (accounting for 35.7%), mainly newly invented, high-cost drugs.

Many medical facilities have proposed adding cancer treatment drugs to the list of drugs covered by health insurance - Photo: D. LIỄU

In an interview with the press on February 26th, the leaders of the Health Insurance Department (Ministry of Health) stated that the unit is reviewing, updating, and revising the list of drugs covered by health insurance.

Updating the list after many years

According to the Health Insurance Department, in recent years, although the percentage of spending on drugs in the total health insurance expenditure has tended to decrease, the absolute value remains very large.

In 2022, the cost of drugs from the health insurance fund was 40.01 trillion VND (33.41%); In 2023, the figure was 45,841 trillion VND (32.82%); in 2024, it increased to 50,784 trillion VND (31.22%).

"This shows that the rational selection and payment of medicines plays a crucial role in controlling treatment costs and ensuring the safety of the health insurance fund," said the head of the Health Insurance Department.

According to current regulations, the payment of medicines under health insurance is carried out according to Circular No. 20, effective from March 1, 2023, with a list including 1,037 active ingredients of chemical and biological drugs (divided into 27 major groups) and 59 radioactive drugs and markers.

However, this list is mainly inherited from 2018, only adding some drugs for treating COVID-19 and expanding the scope of use to commune health stations.

Given the increasing demand for treatment and the rapid development of modern medicine, the Ministry of Health has assigned the Health Insurance Department to lead the review, updating, and revision of the list. The drafting process adheres to the prescribed principles and criteria, ensuring scientific accuracy, transparency, and drawing on international experience.

The most significant additions are to the list of cancer treatment drugs.

According to the draft, 84 new drugs will be added to the list of chemical and biological drugs. Notably, 30 of these are cancer treatment drugs (accounting for 35.7%), primarily newly discovered drugs such as targeted therapies, monoclonal antibodies, and immunotherapy drugs.

According to the Health Insurance Department, although the treatment costs for these drugs are often high, adding them to the health insurance list is necessary to provide doctors with more treatment options, patients with access to advanced treatment protocols, reduce out-of-pocket expenses, and lessen the burden of disease for cancer patients.

Accordingly, to ensure the affordability of the health insurance fund, all cancer drugs have been thoroughly researched and calculated, especially considering the budgetary impact to determine appropriate reimbursement rates.

In particular, in recent years, the number of newly invented and registered cancer drugs in Vietnam has increased rapidly, resulting in a higher number of drugs being considered for updating in this revised list compared to other groups.

The list of drugs covered by health insurance is regulated by active ingredient name, so in reality, the number of commercially available drugs reimbursed by the health insurance fund is even greater, depending on the number of drugs licensed for circulation.

"These are high-cost drugs, but they are necessary to help patients access advanced treatment regimens, reduce the burden of prolonged costs, and limit the risk of being 'left behind' for cancer patients," a leader of the Health Insurance Department informed.

In addition, the draft adds 24 drugs for treating chronic diseases such as cardiovascular, diabetes, respiratory, mental, and urinary diseases…; Simultaneously, the draft includes 18 drugs for treating rare diseases, 14 of which belong to the cancer group.

These diseases often require long-term treatment and high costs, so expanding the list is expected to help patients reduce direct out-of-pocket expenses and improve their quality of life.

In addition to adding new drugs, the draft also proposes amending the conditions and reimbursement rates for 52 existing drugs, with many drugs having expanded scope of use and increased reimbursement rates, thereby increasing access to treatment for patients.

"If approved, the new list of drugs covered by health insurance is expected to better meet treatment needs, help people access modern medical advances, and gradually reduce the burden of out-of-pocket medical costs," a leader of the Health Insurance Department informed, adding that the new list of drugs covered by health insurance is expected to be finalized by the end of the first quarter of 2026 and the circular will be issued in 2026 to soon include more quality, reasonably priced drugs for patients.