ArticlePDF Available

Health Technology Assessment and Its Application in Vietnam

Authors:

Abstract

With the aim of achieving universal health coverage in Vietnam, one of the most pressing issues is to improve the performance and efficiency of the health care system, especially in terms of financial resource allocation and use. In order to support policymakers in making evidence-informed decisions, health technology assessment (HTA) is considered as an effective tool to improve the efficiency of the health system. However, the foundation of selected health care services (i.e. drugs, medical devices) paid by the National Health Insurance Fund (managed by Vietnam Social Security) is not based on scientific evidence or health technology assessment (HTA) studies such as cost-effectiveness evaluation (CEA), cost benefit analysis (CBA), or cost utility analysis (CUA). While there were some public and private entities starting to adapt for conducting HTA in Vietnam such as Vietnam Health Economics Association (VHEA), Health Economics Research and Consulting Center (HERCC), Health Strategy and Policy Institute (HSPI), and Hanoi Medical University, however HTA development is still quite ad hoc and is lacking direction and management from the Government. Therefore, the Ministry of Health (MoH) has started to pay attention to the development of HTA in recent years. The Ministry of Health has designated the Health Strategy and Policy Institute (HSPI) as the focal point for coordinating HTA activities in Vietnam with the purpose of ensuring a close and effective coordination between policy makers, research institutions and other stakeholders.
5
News Across Asia
Copyright © 2017, International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
Health Technology Assessment and Its Application in Vietnam
Tuan Quang Kieu, Health Insurance Department, Ministry of Health, Viet Nam
With the aim of achieving universal health coverage in Vietnam, one of the most pressing issues is to improve the per-
formance and efficiency of the health care system, especially in terms of financial resource allocation and use. In order to sup-
port policymakers in making evidence-informed decisions, health technology assessment (HTA) is considered as an effective
tool to improve the efficiency of the health system. However, the foundation of selected health care services (i.e. drugs, medical
devices) paid by the National Health Insurance Fund (managed by Vietnam Social Security) is not based on scientific evidence
or health technology assessment (HTA) studies such as cost-effectiveness evaluation (CEA), cost benefit analysis (CBA), or cost
utility analysis (CUA). While there were some public and private entities starting to adapt for conducting HTA in Vietnam such as
Vietnam Health Economics Association (VHEA), Health Economics Research and Consulting Center (HERCC), Health Strategy
and Policy Institute (HSPI), and Hanoi Medical University, however HTA development is still quite ad hoc and is lacking direction
and management from the Government. Therefore, the Ministry of Health (MoH) has started to pay attention to the development
of HTA in recent years. The Ministry of Health has designated the Health Strategy and Policy Institute (HSPI) as the focal point
for coordinating HTA activities in Vietnam with the purpose of ensuring a close and effective coordination between policy mak-
ers, research institutions and other stakeholders. There were several key activities that have been conducted by stakeholders
over past few years:
1. Framework of HTA development plan in Vietnam was developed in 2014
2. Topic selection for HTA has been conducted by MoH from 2014 - 2015 under technical support by international partners
such as NICE and HiTAP
3. Several HTA studies and systematic review have been conducted in Vietnam recently: For example: (i) Cost effectiveness of
Peginterferon Alfa-2b or Alfa-2a with Ribavirin for Hepatitis C in Vietnam; (ii) Cost effectiveness of MRI service in Vietnam; (iii)
Cost-effectiveness of trastuzumab in metastatic breast cancer in Vietnam
4. National Health Insurance Policy Consulting Committee (NHIPCM) has been established from 2016 with three taskforces
including an HTA group. Those members will be responsible for advising and consulting for NHIPCM in technical review for
HTA’s evidence
5. Vietnam has become a member of International HTA organization HTAsiaLink (http://www.htasialink.org/member/
member.php) from the Asia Pacific region and hosted the successful 6th HTAsiaLink Annual Conference in Hanoi from 17
to 20 April, 2017 focusing on the topic “Health Technology Assessment in designing and implementing Benefit Packages for
Universal Health Coverage”
6. HTA Guideline is in the first stages of development in Vietnam and it will be completed in October 2017
While some important steps in the development and implementation of an HTA system in Vietnam have been established,
some obstacles need to be resolved to see potential improvements of HTA in Vietnam such as capacity building, HTA funding,
HTA legislation and official organizational structure, the scope of HTA implementation, decision criteria, quality, timelines, and
transparency of HTA implementation, problems in collecting local data, and developing questionnaires to measure outcomes
(QALY, DALY).
According to Vietnam Social Security (VSS), while 22% of
expenditure on selected medicines reimbursed through
Health Insurance Fund are considered to be for appropriate
indications, more than half of the spending (51%) goes to
medicines considered inappropriate for specified indications.
This reveals that an unnecessary amount of health care ex-
penditure is spent each year on medicines, sometimes with-
out adequate evidence on medicines’ safety, effectiveness as
well as value for money. There is a huge opportunity for the
Vietnamese government to develop a more effective and
efficient benefits package, based on stronger scientific evi-
dence, in addition to local inputs by health care providers.
IS S N 23 08-1 9 45
Volume 6 Number 1
April-June 2017
... Vietnam, in 2013, assigned the Health Strategy and Policy Institute (HSPI) to be the focal point for the development of HTA. Although the use of HTA in Vietnam is still at an early stage, it has become necessary to support policymakers in making difficult healthcare resource decisions, and a unit dedicated to HTA will soon be established [24]. In the remaining countries, that is, Myanmar and Lao PDR, HTA research is only conducted occasionally as these countries are in the early stages of establishing information systems and developing HTA capabilities. ...
Article
Full-text available
Background: Progress towards achieving Universal Health Coverage and institutionalizing healthcare priority setting through health technology assessment (HTA) in the Association of South-East Asian Nations (ASEAN) region varies considerably across countries because of differences in healthcare expenditure, political support, access to health information and technology infrastructure. To explore the status and capacity of HTA in the region, the ASEAN Secretariat requested for member countries to be surveyed to identify existing gaps and to propose solutions to help countries develop and streamline their priority-setting processes for improved healthcare decision-making. Methods: A mixed survey questionnaire with open- and closed-ended questions relating to HTA governance, HTA infrastructure, supply and demand of HTA and global HTA networking opportunities in each country was administered electronically to representatives of HTA nodal agencies of all ASEAN members. In-person meetings or email correspondence were used to clarify or validate any unclear responses. Results were collated and presented quantitatively. Results: Responses from eight out of ten member countries were analysed. The results illustrate that countries in the ASEAN region are at different stages of HTA institutionalization. While Malaysia, Singapore and Thailand have well-established processes and methods for priority setting through HTA, other countries, such as Cambodia, Indonesia, Lao PDR, Myanmar, the Philippines and Vietnam, have begun to develop HTA systems in their countries by establishing nodal agencies or conducting ad-hoc activities. Discussion and conclusion: The study provides a general overview of the HTA landscape in ASEAN countries. Systematic efforts to mitigate the gaps between the demand and supply of HTA in each country are required while ensuring adequate participation from stakeholders so that decisions for resource allocation are made in a fair, legitimate and transparent manner and are relevant to each local context.
ResearchGate has not been able to resolve any references for this publication.