Transcript The New Generation of Essential Medicines: Vietnam…now Dr Socorro Escalante Technical Officer-Pharmaceuticals Country Office for Vietnam WHO Country Office for Viet Nam.

The New Generation of
Essential Medicines:
Vietnam…now
Dr Socorro Escalante
Technical Officer-Pharmaceuticals
Country Office for Vietnam
WHO Country Office for Viet Nam
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
WHO Country Office for Viet Nam
Vietnam Now: key events leading
to the present situation
Doi moi
1980’s
Decentralization
Donor
Presence
WTO
Hospital
Reforms
1996
2000’s
2007
2008
WHO Country Office for Viet Nam
Outcomes and impact to medicines access
WHO Country Office for Viet Nam
Current Issues that need attention
Prices
Quality
and Safety
Inequities
Medicines
Use
Policy Coherence
WHO Country Office for Viet Nam
Current Issues that need attention
Prices of Medicine
Table 2. MPR across countries in Asia
Year of
Public Sector
Country
Procurement
Survey
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
Thailand
2006
1.46
4.36
2.55
11.6
3.31
China,
Shanghai
2006
1.52
5.64
2.03
8.76
1.77
5.48
2.6
Source: Data retrieved from WHO/HAI Medicines Prices Database:
WHO Country Office for Viet Nam
4.17
Current Issues that need attention
List of 10 Provinces/cities- Drug expenditure reimbursement is the highest in 2009
Drug expenditure reimbursement in 2009 (1000VND)
No
Province/city'
s name
Inpatient
Rate
Province's
drug cost/
national total
cost of drug
(%)
Cumulative
Rate
Outpatient
Total Cost
910,359,625
1,011,622,566
1,921,982,191
20.49%
20.49%
1,032,747,368
553,099,628
1,585,846,996
16.91%
37.40%
1
Hochiminh
2
Hanoi
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%
7
Binh 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%
5,146,401,156
9,378,885,239
US$ 468 M
100.00%
National total cost
of drug
4,232,484,083
WHO Country Office for Viet Nam
Current Issues that need attention
Inefficient procurement systems that impacts on medicines expenditures
Fig 7. Price variation of winning bid prices across hospitals for
Gliclalazide, 80 mg
Gliclazide 80 gm: Price variation among hospitals
2500
Price (VND)
2000
1500
LP
Median
HP
1000
500
0
HP1
HP2
H3
H4
Hospitals
Source: Analysis of hospital procurement data, 2009, WCO Vietnam
WHO Country Office for Viet Nam
Strategic response and directions
…by the Government
1.
2.
3.
4.
5.
6.
7.
Socio Economic Development Plan
Pharmaceutical law
Local production policy
Drug price control
National Medicines Policy
Essential Medicines List
5 Good Practices Program
WHO Country Office for Viet Nam
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’
WHO Country Office for Viet Nam
Strategic response and directions: The new
generation
WHO Country Office for Viet Nam
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 hospital
3. Coordination across agencies and donors
4. Drug Price Control Policies
WHO Country Office for Viet Nam
thank you
WHO Country Office for Viet Nam