Circular No. 55/2017/TT-BYT promulgates the Circular on the rate of drug loss and the settlement of drug loss costs at medical examination and treatment facilities.

CIRCULAR

Regulations on the rate of drug loss and payment for drug loss costs

at medical examination and treatment facilities

Pursuant to Law No. 105/2016/QH13 dated April 6, 2016 on pharmaceuticals;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Drug Administration Department,

a) Implementing activities to prevent and control infectious diseases, HIV/AIDS: monitoring, early detection, vaccination, preventive treatment, implementing epidemic control measures, and mitigating the consequences of epidemics; preventing and controlling risk factors for the emergence and spread of epidemics and diseases;policies Issuing this Circular to regulate the rate of drug loss and payment for drug loss costs at medical examination and treatment facilities.

Article 1. Scope of Regulation

1. This Circular stipulates the maximum rate of drug loss that can be reimbursed from health insurance funds; principles for determining and evidence proving drug loss during storage, preservation, transportation, distribution, compounding, dose division, and use of drugs at medical examination and treatment facilities that have signed medical examination and treatment insurance contracts with health insurance agencies.

2. This Circular does not apply to traditional herbal medicines and traditional medicinal ingredients.

Article 2. Interpretation of Terms

In this Circular, the following terms are understood as follows:

1. Drug loss refers to the shortage of drugs in quantity during the processes of storage, preservation, transportation, distribution, compounding, dose division, and use of drugs at medical examination and treatment facilities.

2. The value of drug loss for each type of drug is calculated by multiplying the quantity of lost drugs by the purchase price of the drug at medical examination and treatment facilities as prescribed by law, specifically:

Value of drug loss (VND) = Quantity of lost drugs x Purchase price of drug (VND)

3. Rate of drug loss for each type of drug is the percentage (%) of the value of drug loss during the processes of storage, preservation, transportation, distribution, compounding, dose division, and use of drugs at medical examination and treatment facilities compared to the total value of all types of drugs used at the facility in the settlement year, specifically:

Rate of drug loss for drug A (%) = (Value of drug loss for drug A (VND) / Total value of drugs used at the facility (VND)) x 100

4. Rate of drug loss at medical examination and treatment facilities is the sum of the rates of drug loss for each type of drug used at the medical examination and treatment facility in the settlement year.

Article 3. Principles for determining drug loss and paying drug loss costs

1. Determining drug loss for payment is based on the cases of drugs eligible for loss reimbursement as stipulated in Article 4 of this Circular and evidence proving drug loss as stipulated in Article 5 of this Circular.

2. Management, determination, and payment of drug loss costs are based on the actual value of drug loss for each type of drug used at the medical examination and treatment facility.

3. The rate of drug loss at medical examination and treatment facilities to be reimbursed shall not exceed the provisions set forth in Clause 1 of Article 6 of this Circular.

Article 4. Cases of drugs eligible for loss reimbursement

1. Emergency drugs, antidotes, rare drugs required to be stored for treatment purposes at medical examination and treatment facilities that have exceeded their expiration date: Reimbursement for the cost of loss for the quantity of expired drugs in the storage and preservation process at medical examination and treatment facilities.

2. Drugs damaged or broken during the storage, preservation, transportation, distribution, dose division, and use processes at medical examination and treatment facilities due to objective reasons unrelated to the staff's responsibility in performing their duties.

3. Drugs lost during the compounding and dose division process before being distributed to patients.

Article 5. Documents for settlement of drug losses

Medical examination and treatment facilities shall provide the following documents to be considered and settled for drug loss costs as specified in Article 4 of this Circular:

1. A summary record of the list of lost drugs from departments and wards with confirmation of reasons according to the model prescribed in Appendix I attached to this Circular.

2. A confirmation record of expired emergency drugs, antidotes, rare drugs, or a confirmation record of damaged or broken drugs during storage, preservation, transportation, distribution, dosage division, and use at medical examination and treatment facilities according to the model prescribed in Appendix II attached to this Circular.

3. A periodic inventory record of drugs at medical examination and treatment facilities according to the model prescribed in Appendix III attached to this Circular.

4. An annual meeting record of the Drug Inventory Committee at medical examination and treatment facilities, with the participation of the Social Insurance Agency that has signed a medical examination and treatment insurance contract with the facility, identifying lost drugs that meet the provisions of Article 4 of this Circular.

5. The drug compounding and dosage division process issued by medical examination and treatment facilities clearly defining the loss rate of each drug during this process. Determining this loss rate must have a meeting record and consensus between the Social Insurance Agency that has signed a medical examination and treatment insurance contract with the facility and the medical examination and treatment facility.

Article 6. Guidelines for Settlement of Drug Loss Costs

1. The maximum allowable loss rate for drug items used at medical examination and treatment facilities compared to the total value of drugs used in the settlement year is 0.1%.

2. Settlement of drug loss costs is based on the actual loss value of drugs during storage, preservation, transportation, distribution, compounding, dosage division, and use at medical examination and treatment facilities but shall not exceed the maximum allowable loss rate stipulated in Clause 1 of this Article. In cases where the drug loss has already been included in the economic and technical norms set by competent state authorities, such losses must be excluded.

Article 7. Effective Date

This Circular takes effect from March 1, 2018.

Article 8. Reference Provisions

In case the regulatory legal documents and provisions cited in this Circular are amended, supplemented, or replaced, they shall be implemented according to the new regulatory legal documents.

Article 9. Responsibility for Implementation

1. The Department of Medicines Management is responsible for leading and guiding the application of drug loss rates at medical examination and treatment facilities.

2. The Department of Planning and Finance is responsible for guiding the management and settlement of drug loss costs in medical examination and treatment facilities.

3. Medical facilities shall be responsible for:

a) Organizing the management of stages that may result in losses and being responsible for compiling reports for drug loss settlements based on the actual quantity of lost drugs and in accordance with the drug loss rate regulations set out in this Circular;

b) Before January 15 each year, medical examination and treatment facilities shall submit the drug loss settlement request documents to the Social Insurance Agency that has signed a medical examination and treatment insurance contract with the facility to be considered for the settlement of drug loss costs according to this Circular;

c) In cases where abnormal drug losses occur exceeding the maximum allowable drug loss rate for settlement as stipulated in this Circular, medical examination and treatment facilities shall be responsible for determining the cause of the loss and taking timely measures to prevent and minimize drug loss costs to the lowest extent possible;

4. The Social Insurance Agency that has signed a medical examination and treatment insurance contract with medical examination and treatment facilities shall be responsible for implementing the settlement according to this Circular within thirty days from the date of receipt of complete drug loss cost settlement request documents from the medical examination and treatment facility.

During implementation, if any issues arise, it is requested that relevant agencies, organizations, and individuals promptly report to the Ministry of Health (Department of Medicines Management, Department of Planning and Finance) for consideration and resolution./.