In 2013, HIU received a request from the Rockefeller Foundation, to support the development of UHC in Vietnam. Since then, the Vietnam engagement has moved under the umbrella of iDSI projects. The Health Strategy and Policy Institute (HSPI), was appointed by the Ministry of Health to be the country focal point on HTA. As such our efforts are directed towards strengthening HSPI. With support from HIU, the local team, led by HSPI, in collaboration with the Hanoi School of Public Health (HSPH) and Hanoi Medical University (HMU), initiated country demonstration projects as well as integrated HTA in policy decision-making.
Demonstration Projects
The following two studies were initiated in 2014 and completed in 2015. Both topics were selected during a topic selection workshop with stakeholders using a set of criteria developed by the HSPI with technical support and guidance from HIU.
- Cost-effectiveness of Pegylated-Interferon (peg-IFN) for Treatment of Chronic Hepatitis C Infection: Peg-IFN is a medicine used for the reatment of chronic hepatitis C infection, which is currently in the reimbursement list in Vietnam. However, the conditions for reimbursement are difficult to follow and therefore limits coverage. The study was then conducted to evaluate the cost-effectiveness and budget impact of the use of peg-IFN to inform the potential means to increase access to the medicine. The study revealed that peg-IFN is more cost-effective than palliative care despite high budget implication. The implementation of the study findings is under consideration.
- Cost-effectiveness of trastuzumab for breast cancer: Trastuzumab, used in breast cancer patients who are HER2 positive, is currently not in the reimbursement list but the government has decided to subsidize the use of the medicine for this indication. The concern is whether the medicine is cost-effective. The findings suggested that trastuzumab is not cost-effective and the budget impact is very high.
Further ongoing projects include:
- Magnetic Resonance Imaging (MRI) and its diffusion and utilization: The study started in 2014 with the objective of exploring the number, diffusion, and utilization of MRI devices, an imaging technology. Systematic reviews, health facility survey and consensus survey were conducted to obtain the data. The project is ongoing.
- The review of interventions in the benefits package to inform the development of the Basic Health Service Package (BHSP) in Vietnam: Currently, the benefits package in Vietnam covers a broad range of interventions (more than 20,000 items in total) without specifying indications for the use of the interventions. With the aim to rationalize the inclusion and the use of interventions in the BHSP, the first phase of the project initiated in 2016. Interventions with high spending by Vietnamese Social Security (VSS) were selected for review. During the first phase, 21 interventions have been reviewed which account for approximately 20{1a845494bf7a4202a6ed9c7b5a62c78959ed2a3357567d4a5a582718b3c9f3bb} of spending on medicines and 12{1a845494bf7a4202a6ed9c7b5a62c78959ed2a3357567d4a5a582718b3c9f3bb} of spending on medical devices. Evidence on safety, clinical efficacy or effectiveness, and value for money of those selected interventions were retrieved from international literature and were triangulated with data on the real use of the interventions in Vietnam collected from selected provinces. The preliminary results of the interventions reviewed were well received and generated discussions after being presented to experts including the Vice Minister of Health. VSS is planning to circulate notifications to limit the inappropriate use of the interventions based on the result of the review. The continuation of the second phase of the project is now under discussion.
Intensive Training Courses:
Delegates from Vietnamese Ministry of Health and partners have visited HITAP for study visits on several occasions. In Feb 2014, the delegates visited HITAP to learn about HTA and its policy use and implication in Thailand for a week. Moreover, in 2015, the delegates came to HITAP for 3 days to learn and discuss about the establishment of the Council for BHSP, which would overlook the development of the benefits package for universal health coverage in Vietnam. HIU coordinated with HITAP researchers and experts from Thai partner organizations to provide training and experience sharing.
Three-Year Work Projection:
- Support the development of HTA roadmap including strategic and business plan for a focal priority setting institution by Vietnamese authorities
- In collaboration with NICE International, support the development of the process and methods guide for HTA and HBP design, co-developed and adopted by the relevant authorities (VSS and MoH)
- Support the implementation of the HTA studies produced in healthcare policy decisions (for example, adjustments to the HBP).
The Ho Chi Minh Mausoleum is the final resting place of Vietminh leader Ho Chi Minh in Hanoi, Vietnam. It is a large building located in the center of Ba Dinh Square, where Minh, Chairman of the Communist Party of Vietnam from 1951 until his death in 1969, read the Declaration of Independence on 2 September 1945, establishing the Democratic Republic of Vietnam. It is also known as Ba Đình Mausoleum and is open to the public.(Source:Wikipedia)
