Health expenditure nationwide has grown rapidly, from $17.4 billion in 2019 to an estimated $27.5 billion in 2025, and is forecast to hit $34.1 billion by 2028, Ong The Duy from the ministry’s Health Strategy Institute said on Dec. 24.
Drug spending alone rose from $4.7 billion to $6.9 billion over the same period, making pharmaceuticals the biggest cost for both patients and health insurance, accounting for more than 30% of total insurance spending.
Experts say several forces are driving costs up: an aging population, rising rates of chronic diseases such as cardiovascular illness, diabetes and cancer, and growing expectations for higher-quality treatment and newer, specialized drugs, often with much higher price tags.
Vietnam is now the second-largest pharmaceutical market in Southeast Asia, trailing only Indonesia.
But soaring drug prices are putting increasing pressure on patients and the health insurance fund, especially with long-term treatments and high-cost specialty medicines. New drugs tend to be expensive, and limited early clinical data can make it difficult for insurers to approve coverage without risking financial strain.
To address this, specialists recommend risk-sharing agreements (RSS), a model where regulators, insurers and drug manufacturers jointly manage costs and treatment outcomes. These agreements can be financial-based or results-based, and aim to expand access to innovative medicines while controlling budget risk.
Several countries already use similar models. The U.K.’s Cancer Drugs Fund, with an annual budget of GBP 340 million, allows early access to cancer drugs while collecting real-world data for later evaluation. From 2016–2023, the program supported over 88,000 patients, covering 102 drugs across 241 indications.
Vietnamese experts suggest starting with pilot programs, clear data standards and transparent oversight, before scaling up nationally.
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