THE MINISTRY OF
HEALTH
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SOCIALIST REPUBLIC
OF VIETNAM
Independence - Freedom - Happiness
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No. 31/2011/TT-BYT
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Hanoi, July 11th
2011
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CIRCULAR
ISSUING
AND GUIDING THE IMPLEMENTATION OF THE LIST OF ESSENTIAL MEDICINES USED AT
MEDICAL FACILITIES AND COVERED BY THE HEALTH INSURANCE FUND.
Pursuant to the Law
on Medical examination and treatment dated November 23rd 2009;
Pursuant to the Law
on Pharmacy dated June 14th 2005; the Government's Decree No. 79/2006/NĐ-CP
dated August 09th 2006, specifying the implementation of a number of
articles of the Law on Pharmacy;
Pursuant to the Law
on Health insurance dated November 14th 2008; the Government's
Decree No. 62/2009/NĐ-CP dated July 27th 2009, specifying and
guiding the implementation of a number of articles of the Law on Health
insurance;
Pursuant to the
Government's Decree No. 188/2007/NĐ-CP dated December 27th 2007,
defining the functions, tasks, powers and organizational structure of the
Ministry of Health;
Pursuant to the Joint
Circular No. 09/2009/TTLT-BYT-BTC dated August 14th 2009 of the
Ministry of Health and the Ministry of Finance, guiding the health insurance;
The Ministry of
Health issues and guided the List of essential medicines at medical facilities
covered by the health insurance fund (hereinafter referred to as the list of
medicines) as follows:
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Promulgated together
with this Circular the “List of essential medicines used at medical facilities and
covered by health insurance, including:
1. The List of medicines.
2. The List of radiopharmaceuticals
and tracers.
Article
2. List structure
1. The list of
medicines.
a) The list comprises
900 medicines or active ingredients, sorted by the Anatomical Therapeutic
Chemical
classification system (ATC code); named according to international names, and
in accordance with the Vietnam’s National Pharmacopoeia. An active ingredient
that has more than one ATC code or indication shall be classified into the most
suitable group to avoid duplication.
b) The medicine list
has 8 columns:
- Column 1 indicates ordinal
numbers according to the names of medicines or active ingredients;
- Column 2 indicates ordinal
numbers of the medicines or active ingredient in the list;
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- Column 4 indicates routes
of administration dosage forms
- Column 5 indicates
the use for hospitals in special class and 1st class;
- Column 6 indicates
the use for hospitals in 2nd class;
- Column 7 indicates
the use for hospitals in 3rd class and 4th class;
- Column 8 indicates
the use for private clinics and other medical facilities.
2. The list of radiopharmaceuticals
and tracers include 57 active ingredients, named after international names,
sort by alphabetical order, and has 5 columns, including:
- Column 1 indicates
the ordinal numbers;
- Column 2 indicates
the names of radiopharmaceuticals and tracers;
- Column 3 indicates
the routes of administration;
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- Column 5 indicates
the unit;
Article
3. The use of the medicine list
1. Medicines.
a) Medicines are used
in accordance with the class of hospitals. Specialized medicines are used in
accordance with the management decentralization and medicine practice.
b) The medicines
marked with (*) are backup drugs, restricted from use. These medicines are only
used when other medicines in the group are not effective, and medical
consultation is compulsory (except for emergency treatment);
c) The medicines that
are used to treat the diseases in another group shall be covered by the health
insurance fund if the indication is given as registered in the issued medicine
registration dossier;
d) The medicines
classified as antineoplastic drugs, immunosuppressive drugs
- The medicines
indicated to treat cancer, including the medicines not in the list of the
Ministry of Health are only used at medical facilities licensed to treat
cancer, and indicated by the doctors that have been trained in oncology;
- The medicines indicated
to treat other diseases other than oncology shall be used at the hospitals or
clinic wards other than cancer ward according to the treatment regimen provided
by the hospital. The consultation with oncologists is required to ensure the
safety and treatment efficiency.
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2. Radiopharmaceuticals
and marking compounds in the list shall be subject to special control. The
supply, use, and management of them must be conformable with the regulation on
medicines, and the law on radiation control and safety.
Article
4. Compilation of the List of medicines in medical facilities
1. According to
Article 2 and Article 3 of this Circular; the technical classification, the
illness models, and the hospital budget, the Director of the hospital shall
appoint the Treatment and Medicine Panel to compile the internal List of
Medicines, and make plans for supplying medicines that satisfy the treatment
demand in accordance with the laws on bidding for medicine supply. The Director
of the Service of Health shall direct the compilation of the List of medicines
used for commune medical stations.
2. The finished
medicines shall be selected as follows: generic medicines, mono-substance
medicines, medicines produced at home, medicines produced by the facilities
that follow the Good manufacturing practices (GMP) shall be preferred.
3. The medical
facilities shall ensure the prompt and adequate supply of medicines, avoid
patients buying medicines themselves, including anti-cancer drugs, immunosuppressive
drugs that
are not in the list but covered by the health insurance fund as prescribed.
Article
5. The patients’ payment for medicines
1. For the list of
medicines.
a) The health
insurance shall cover other chemical forms of a pharmaceutical substance if they
have the same indication;
b) A medicine shall
be covered if its route of administration and dosage form is provided in the
list. The sublingual or medicines that are sucked, chewed, or sublingually
administered shall be covered by the health insurance fund similarly to orally administered
medicines; the medicines that are externally rubbed or adhered shall be covered
similarly to topically administered medicines; The medicines of which the
routes of administration are intramuscular injection, intradermal injection, intravenous
injection, intravenous infusion, intra-articular injection, and intracavitary
injection shall be covered similarly to the medicines of which the route of
administration is injection.
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d) When a hospital
provide technical services of a hospital in a higher class, the medicines used
by the latter may be used.
2. The specialized
medicines produced by the hospitals must ensure the quality as prescribed. The
medicine prices shall be covered by the health insurance fund based on the
prices of ingredients provided by the Director of the hospital. The Director
shall be responsible for before law for such ingredient prices.
3. For non-public
medical facilities, depending on the list of technical services approved by
competent agencies, the list of medicines shall be compiled under an agreement
with the social insurance agency for paying the cost of medicines for the
patients that have health insurance as prescribed.
4. The expenditure on
medicine included in the price of technical services (such as desensitizers, anaesthetics,
and infusion fluid used during surgeries, procedures, or radiocontrast media in
medical imaging) shall not be paid again. The medicines in XV group –
Disinfectants and antiseptics shall be paid together with the technical
services and, not be paid separately.
5. If the patient
only uses part of the dosage in the smallest unit under professional indication
(e.g. paediatric medicines, oncological medicines), and the residual amount is
not used (e.g. no patient, not enough dose, the medicines are expired), the
health insurance fund shall pay the cost of the smallest unit.
6. The health
insurance fund only pay for a number of medicines with the following
indications:
a) Interferon and
peginterferon used to treat hepatitis C
in
accordance with the
treatment regimen.
b) Rituximab used to
treat Non-Hodgkin Lymphoma with positive CD20.
c) Sorafenib used to
treat developing liver cancer and kidney cancer;
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dd) Nimodipin used to
treat meningeal hemorrhage due to cerebral aneurysm or injuries.
Article
6. The order and procedure for requesting the amendment, supplementation, and
revision of the list of medicines
1. Annually,
depending on the need for treatment, the medical facilities shall suggest the amendment,
supplementation, and revision of the List of medicines to suit the practice in
accordance with the following targets and rules:
a) Target:
- Ensure the safe,
reasonable, and effective use of medicines;
- Satisfy the need
for treatment of patients;
- Ensure the
entitlement to medicines of the patients that have health insurance;
- Suitable for the
financial capability of patients and the health insurance fund.
b) Rules:
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- The medicines are
effective in treatment;
- Do not suggest the
list of medicines not recommended by WHO, the Ministry of Health, or medicines
that are obsolete and have many side effects to the List of medicines;
- The amendment,
supplementation, and revision must be suggested by the Treatment and Medicine
Panel of the hospital.
2. The medical
facilities shall send written request (according to the Annex enclosed with
this Circular) to the Ministry of Health (The Department of Medical Examination
And Treatment Management) or the provincial Services of Health for considering
the amendment, supplementation, or revision.
Article
7. Implementation responsibilities
1. The list of
medicines promulgated together with this Circular is the basis for medical
facilities to select medicines, and satisfy the need for treatment and medicine
payment of patients.
2. The social insurance
agency and medical facilities shall cover the cost of medicines for the
patients that have health insurance as prescribed in this Circular..
Article
8. Effects
This Circular takes
effect on August 25th 2011. The List of medicines, the List of radiopharmaceuticals
and tracers, and the guide to the List of essential medicines used at medical
facilities promulgated together with the Decision No. 05/2008/QĐ-BYT dated
February 01st 2008 of the Minister of Health, on the promulgation of
the List of essential medicines used at medical facilities, are annulled The
Circular No. 02/2010/TT-BYT dated January 15th 2010 of the Minister
of Health, promulgating the list of supplementary medicines used for children
under 6 years old and covered by the health insurance fund is annulled.
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FOR THE MINISTER
DEPUTY MINISTER
Nguyen Thi Xuyen
ANNEX
(Application form for
amending and supplementing the List of Medicines promulgated together with the
Circular No. 31/2011/TT-BYT dated July 11th 2011 of the Minister of
Health)
The Ministry of
Health (or the Service of Health).……………
Hospital:……………………
APPLICATION
FOR REVISING, AMENDING AND SUPPLEMENTING THE LIST OF ESSENTIAL MEDICINES USED
AT MEDICAL FACILITIES
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No.
Name of active
ingredient
Proprietary name
ATC Code
Dosage Form
Pharmacological
effects and indications
Registration number
Reference
Notes (reason)
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2.
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3.
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4.
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5.
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6.
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Date:
Director
(Signature and seal)
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