Thousands of Vietnamese cancer patients who rely on state-run health insurance for their medication may have to abandon their treatment because of a recent government decree barring drugs that lack the required papers from being imported into the country.
Though the drugs are available commercially, they are too expensive for financially disadvantaged patients to afford without some form of sponsorship.
In Vietnam, nearly 82 percent of the population is covered by a state-run health insurance program in which the government shares the cost of medical treatments with the patient, according to statistics made available last April by Vietnam Social Security.
A sponsorship program offered by the Swiss-based Novartis Pharma Services AG provides insured Vietnamese cancer patients with free access to two cancer-treating drugs; Glivec 100mg and Tasigna 200mg.
The pharmaceutical company sponsors 100 percent of the cost of the drugs for patients who have been insured for less than 36 months.
For patients who have been insured for 36 months or more, their insurance covers 40 percent of the cost, while Novartis takes care of the remaining 60 percent.
The sponsorship was previously set to be available from January 1, 2015 until December 31, 2019 at seven leading cancer-treatment hospitals throughout Vietnam.
|Cancer patients at the Hospital of Oncology in Ho Chi Minh City. Photo: Tuoi Tre|
However, supply of the drugs has already been exhausted in some locations and is quickly running out at others.
Hundreds of patients diagnosed with chronic myeloid leukemia at the Hospital of Blood Transfusion and Hematology in Ho Chi Minh City (BTH) are now counting their days after the hospital ran out of the sponsored drugs at the beginning of this year.
“Without the sponsorship, many patients will have no choice but to give up their treatment, as the cost of the medication will amount to nearly VND100 million [US$4,400] a day,” one reader told Tuoi Tre (Youth) newspaper.
B., a 39-year-old leukemia patient from Ho Chi Minh City who is receiving treatment at BTH, said his course of Glivec had been reduced from three tablets a day to two pills a day recently due to the shortage.
“I have to buy the drug at the market price of VND3.5 million [$155] for ten tablets while waiting for the sponsored drugs,” B. said.
“If this situation continues, I won’t be able to survive for much longer,” he added.
Thousands of cancer patients at the seven hospitals rely on the sponsored drugs to fight their diseases, and many could be forced to give up their treatments entirely.
|A woman buys medicine at a pharmacy inside the Hospital of Oncology in Ho Chi Minh City. Photo: Tuoi Tre|
The red tape that kills
The shortage of both Glivec and Tasigna has been attributed to a recent government decree that mandates a range of additional papers and certificates for the drugs to be cleared before import into Vietnam.
The decree, which took effect on July 7, 2017, elaborated on the implementation of an earlier Law on Pharmacy.
According to the decree, applications for the import of medicine, even for humanitarian purposes, must include a quality profile of the drug as specified in the ASEAN Common Technical Dossier (ACTD).
However, in a letter sent by the Ho Chi Minh City office of Novartis to a number of Ministry of Health officials and hospitals on July 25, 2017, the company stressed that the ACTD-standard profile would need to include classified information regarding the formula and production of the drug.
Such information, Novartis wrote in its letter, could only be submitted directly to the Ministry of Health for evaluation and not to a third party such as a partnered hospital or the importer of the drug.
“[The decree] requires Novartis to hand these documents to a third party to complete their application for import licensing, which goes against our company’s principles on confidentiality and is an unprecedented requirement for programs that we sponsor,” the company stressed.
Nearly half a year has passed since Novartis sent its letter to the relevant authorities, during which time thousands of cancer patients have waited for their life-saving drugs to become readily available again.