Only doctors who are licensed to practice with oncology or blood transfusion hematology can prescribe cancer drugs in Vietnam?
- Cases where the insurance fund pays the cost of cancer treatment drugs?
- In what cases does the Health Insurance Fund not pay the cost of treatment drugs?
- Are all doctors prescribed cancer drugs in Vietnam? Can cancer treatment drugs in Vietnam be used outside medical examination and treatment establishments with cancer treatment functions?
Cases where the insurance fund pays the cost of cancer treatment drugs?
Pursuant to Article 3 of Circular 30/2018/TT-BYT stipulating the cases where the Health Insurance Fund will pay drug costs as follows:
- The health insurance fund shall pay the cost of drugs according to the actual quantity used for the patient and the purchase price of the medical examination and treatment establishment in accordance with the law on bidding for drug purchase, in accordance with the scope of his/her rights. benefits and benefits according to the provisions of the Law on Health Insurance and guiding documents.
- The health insurance fund will pay in case the drug is prescribed in accordance with the indications in the drug instruction leaflet enclosed with the drug registration dossier licensed by the Ministry of Health or the Ministry of Health's diagnosis and treatment guidelines. Medical. In case there are no indications in the drug instruction leaflet enclosed with the drug registration dossiers licensed by the Ministry of Health, not included in the diagnostic and treatment guidelines of the Ministry of Health, but necessary for treatment, The Ministry of Health will set up a Council to consider each specific case.
- The health insurance fund shall pay for drugs and drug batches that have been issued with a decision on suspension of circulation and withdrawal according to the guiding documents of the Ministry of Health.
In what cases does the Health Insurance Fund not pay the cost of treatment drugs?
Pursuant to Article 3 of Circular 30/2018/TT-BYT stipulating the cases where the Health Insurance Fund will pay drug costs as follows:
- The health insurance fund does not pay for the following cases:
+ The cost of drugs has been incorporated into the price of technical services, medical examination, treatment bed days or package charges according to the case according to current regulations;
+ The cost of drugs already covered by the state budget or other sources;
Drugs used in clinical trials and scientific research.
Only doctors who are licensed to practice with oncology or blood transfusion hematology can prescribe cancer drugs in Vietnam?
Are all doctors prescribed cancer drugs in Vietnam? Can cancer treatment drugs in Vietnam be used outside medical examination and treatment establishments with cancer treatment functions?
Pursuant to the provisions of Article 4 of Circular 30/2018/TT-BYT as amended by Article 1 of Circular 20/2020/TT-BYT, stipulating the payment of the Health Insurance Fund in case of drug use. cancer as follows:
- Other chemical isomers or other salt forms of the active ingredient (including single-component and multi-component combinations, excluding vitamins and minerals) included in the List of drugs in Appendix 01 are protected by the Fund. Health insurance pays if it has the same indication as the chemical form or name of the drug listed on the Drug Formulary.
- Drugs classified in this group used to treat diseases of other groups shall be paid by the Health Insurance Fund if indicated in accordance with Clause 2, Article 3 of this Circular.
- A number of drugs with prescribed conditions and rates of payment shall be paid by the Health Insurance Fund according to the provisions of column 8 of the List of drugs in Appendix 01.
- In case according to professional prescription, the patient only uses a part of the drug in the smallest packaging unit (for example, medicine used in pediatrics, oncology) and the remaining amount cannot be used. (for example, there is no patient with the same indication, the remaining amount of medicine is not enough, the drug's shelf life is over), the Health Insurance Fund will pay the whole amount at the price of the smallest packing unit. .
- Medicines marked with an asterisk (*) are drugs that must be consulted before use, except in emergency cases. For antibiotics marked with an asterisk (*), the Health Insurance Fund will pay when strictly following the consultation process when prescribing according to the Ministry of Health's Guidelines for implementation of antibiotic use management in hospitals. Medical.
- For anti-cancer drugs:
+ Only used for cancer treatment at medical examination and treatment facilities with cancer treatment functions (including oncology, hematology, blood transfusion and nuclear medicine facilities; oncology departments and units) , blood transfusion hematology and nuclear medicine in institutes, specialized or general hospitals) and must be prescribed by a licensed physician, whose specialty is oncology or blood transfusion hematology;
+ In case of being used to treat diseases other than cancer: The health insurance fund will pay according to the diagnosis and treatment guidelines of the Ministry of Health or the hospital. In case there are no guidelines for diagnosis and treatment, consultation with an oncologist is required. In case there is no guideline for diagnosis and treatment and there is no oncologist, it must be consulted under the leadership of the hospital leader before using it.
- Medicines prepared or prepared by medical examination and treatment establishments are paid for by the Health Insurance Fund when:
+ Active ingredients of the drug are on the List in Appendix 01 or Appendix 02;
+ Suitable in terms of route of administration, mode of use, and hospital class used in the List in Appendix 01 or Appendix 02.
+ Used at that medical examination and treatment establishment;
+ The head of the medical examination and treatment establishment is responsible for approving the preparation or preparation process, quality standards, and drug prices; reach agreement with the social insurance agency on drug prices as a basis for payment. Product cost is built on the basis of: cost of raw materials for drug production; loss costs; packaging costs; labor costs; preparation costs include electricity, water, fuel; testing costs and other costs (if any).
As such, it is only used for cancer treatment at medical examination and treatment facilities with cancer treatment functions (including oncology, hematology, blood transfusion and nuclear medicine facilities; departments and units). Oncology, hematology, blood transfusion and nuclear medicine in a hospital, specialized or general hospital) and must be practiced by a licensed physician, the scope of expertise is oncology or hematology only. determined.
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