Pharmaceutical policy in Vietnam

Abstract

Health sector reforms since 1989 have transformed Vietnam’s healthcare system from a publicly funded and provided healthcare system to public-private mix. With the shift toward a market economy, Vietnam has introduced several market-oriented measures including the introduction of user fees, legalization of private pharmacy and medical practices, and liberalization of the production and sale of pharmaceuticals. Private pharmacies have become the dominant medicines supplier in the market. At the same time, the provision of free medicines dispensed through the public health system was discontinued. Spending on medicines, user fees, and increased autonomy for health facilities and healthcare providers led to substantial increases in out-of-pocket health expenditure. Because of high medicine prices, poor quality of medicines, irrational selection and use of medicines, unsustainable pharmaceutical production and distribution systems, and a lack of a financial support system for drug procurement, access to the right medicines at the time people need them remains a major challenge for the majority of the population. A number of legislative and regulatory reforms have been introduced to address the side effects of the market economy on access to essential medicines. The initiatives, however, have not been able to keep up with the rapid changes in the health and pharmaceutical sectors. Furthermore, the provisions were not routinely monitored or effectively enforced.