Directive No. 04/1998/CT-BYT on Strengthening the Rational, Safe, and Economical Use of Medicines at Medical Examination and Treatment Facilities

DIRECTIVE

On Strengthening the Rational, Safe, and Economical Use of Medicines at Medical Institutions

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In recent years, the situation regarding the use of medicines at medical institutions (hereinafter referred to collectively as hospitals) has shown positive changes towards safer, more rational, and effective use, contributing significantly to important tasks in the healthcare sector for the people's health. However, hospitals are increasingly inclined to use imported medicines with rising costs, despite domestic pharmaceutical companies producing similar active ingredients of good quality at reasonable prices. According to statistics, in total expenses for medical treatment from the health insurance fund, medicine costs account for 50%-60% (inpatient treatment) and 70%-90% (outpatient treatment). Imported medicines and branded drugs currently make up a large proportion of medical treatment (over 80%), which has significantly impacted the limited budget for treatment, affected the health insurance fund, and made it difficult for the poor to access medical services.

Implementing Resolution of the Fourth Plenary Session of the Central Committee of the Communist Party of Vietnam, on the viewpoint of promoting internal resources and practicing economy, continuing to improve the management and rational, safe, and economical use of medicines at hospitals, and contributing to the development of the Pharmaceutical Industry in Vietnam, the Minister of Health issues the following directive:

1. Each hospital, based on the advice of the Medicine and Treatment Council (established according to Directive No. 3-BYT/CT dated February 25, 1997 of the Minister of Health), must develop a unified list of medicines for use in the hospital based on Decision No. 517-BYT/QD dated April 10, 1995 concerning the issuance of a temporary list of main medicines used in hospitals not to be purchased by patients.

Prioritize the use of domestically produced medicines that meet quality standards; do not use foreign branded drugs when domestic production offers the same active ingredient under generic or other names; only use foreign branded drugs in necessary cases where domestic alternatives are unavailable. The Hospital Director shall implement measures to strictly monitor and supervise the prescription and administration of imported medicines to patients. The list of medicines used in the hospital serves as the basis for the health insurance agency to reimburse health insurance beneficiaries.

2. Hospitals shall proactively develop plans for the use of medicines on a monthly and quarterly basis. The hospital pharmacy department shall cooperate with domestic pharmaceutical companies to supply medicines in full and on time as stipulated in Directive No. 3-BYT/CT dated February 25, 1997 of the Minister of Health; they are responsible for providing and managing all types of medicines used for inpatient and outpatient treatment according to the hospital's list of medicines. Strictly prohibit the acceptance of medicines or branded drugs promoted or marketed by pharmaceutical companies to doctors for patient treatment.

3. The Department of Treatment - Ministry of Health shall coordinate with the National Drug Administration and the National Health Insurance to establish a list of medicines covered by health insurance, suitable to economic and social conditions and the health insurance fund, to submit to the Minister of Health for approval.

4. The National Drug Administration needs to strictly manage the importation of medicines, limiting the importation of those already produced domestically and of good quality. For medicines without registration numbers and those not yet produced domestically, only essential branded drugs for treatment shall be allowed to be imported, prioritizing generic-named medicines.

5. The Hospital Director shall organize training for doctors directly involved in diagnosis, treatment, and prescription writing, and pharmacists in the principle of increasing the use of domestic medicines, economizing on medical treatment costs to alleviate difficulties for patients and the state budget.

Upon receipt of this Directive, Directors of Provincial Health Departments, heads of units under the Ministry must immediately implement and periodically report the results of implementation to the Ministry of Health. The Department of Treatment is responsible for monitoring, urging, and compiling the implementation of the Directive to report to the Minister of Health.