WHO Country Office for Viet Nam Dr Socorro Escalante Technical Officer-Pharmaceuticals Country...

WHO Country Office for Viet Nam

Dr Socorro EscalanteTechnical Officer-Pharmaceuticals

Country Office for Vietnam

The New Generation of Essential Medicines:

Vietnam…now


Access to essential medicines in Vietnam is shaped partly by the need

and vision for health , and more so by its political and economic

development


Vietnam Now: key events leading to the present

situation

Doi moi DecentralizationDonor

PresenceWTO

HospitalReforms

1980’s 1996 2000’s 2007 2008


Outcomes and impact to medicines access


Current Issues that need attention

Prices Inequities

Qualityand Safety

MedicinesUse

Policy Coherence



Country Year of Survey

Public Sector Procurement Prices

Public Sector Patient Prices

Private Sector Patient Prices

IB LPG IB LPG IB LPG

Viet Nam 2005 8.29 1.82 46.58 11.51 44.61 8.30

Philippines 2005 14.19 5.14 15.31 6.4 17.28 5.24

Malaysia 2004 2.41 1.09 16.5 6.57

Mongolia 2004 2.3 2.6 4.17

Thailand 2006 1.46 4.36 2.55 11.6 3.31

China, Shanghai

2006 5.48 1.52 5.64 2.03 8.76 1.77

Prices of MedicineTable 2. MPR across countries in Asia

Source: Data retrieved from WHO/HAI Medicines Prices Database:



List of 10 Provinces/cities- Drug expenditure reimbursement is the highest in 2009

NoProvince/

city's name

Drug expenditure reimbursement in 2009 (1000VND) Rate Province's drug cost/

national total cost of drug

(%)

CumulativeRateInpatient Outpatient Total Cost

1 Hochiminh 910,359,6251,011,622,56

61,921,982,19

1 20.49% 20.49%

2 Hanoi 1,032,747,368 553,099,6281,585,846,99

6 16.91% 37.40%

3 Thanh Hoa 166,160,826 175,511,838 341,672,664 3.64% 41.04%

4 Nghe An 115,906,718 167,828,905 283,735,623 3.03% 44.07%

5 Hai Phong 126,717,815 86,324,162 213,041,977 2.27% 46.34%

6 Dong Nai 33,094,586 171,991,793 205,086,379 2.19% 48.53%

7Binh Duong 31,231,094 159,362,616 190,593,710 2.03% 50.56%

8 Hue 130,433,756 48,353,316 178,787,072 1.91% 52.47%

9 Da Nang 90,568,694 65,775,941 156,344,635 1.67% 54.13%

10 Binh Dinh 66,585,130 86,793,191 153,378,321 1.64% 55.77%

National total cost of drug

4,232,484,0835,146,401,15

6

9,378,885,239

US$ 468 M 100.00%



Inefficient procurement systems that impacts on medicines expendituresFig 7. Price variation of winning bid prices across hospitals for Gliclalazide, 80 mg

Source: Analysis of hospital procurement data, 2009, WCO Vietnam

Gliclazide 80 gm: Price variation among hospitals

0

500

1000

1500

2000

2500

HP1 HP2 H3 H4

Hospitals

Pric

e (V

ND) LP

Median

HP


Strategic response and directions

…by the Government

1. Socio Economic Development Plan2. Pharmaceutical law 3. Local production policy4. Drug price control5. National Medicines Policy6. Essential Medicines List 7. 5 Good Practices Program


Strategic response and directions: The new generation

Guiding principles:• Policy coherence: Action beyond the

health sector• National-local : Oversight and

guidance rather than just regulations and control

• Evidence: appreciation and relevance into decision making

• Donors: from ‘my fund, my system’ to ‘our fund, our system’


Strategic response and directions: The new generation


Remaining Challenges: Where are we stuck?

1. Policy coherence: NMP envisaged to bring about policy coherence in pharmaceuticals

2. Operational reforms: • neglected partly but have direct impact into

access and inequalities• Procurement inefficiencies and medicines

utilization in hospital3. Coordination across agencies and donors4. Drug Price Control Policies


thank you

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