The issue was discussed at a recent scientific roundtable hosted by the U.S.-ASEAN Business Council on Jan. 8, 2026, in Hanoi, titled “Strategy for transforming end-stage chronic disease treatment in Vietnam – Promoting home-based peritoneal dialysis: ensuring balance, expanding access, and enhancing sustainability.”
In this context, Paul Uthaichalanond, General Manager of Vantive for Malaysia, Thailand, Vietnam and Myanmar, shared regional perspectives on improving access to kidney care, including the role of home-based peritoneal dialysis (PD), which has been implemented in countries such as Thailand.
Paul Uthaichalanond, General Manager of Vantive Malaysia, Thailand, Vietnam, and Myanmar. Photo courtesy of Vantive |
From your regional observations, what are the most critical structural constraints in Vietnam’s current ESRD care system?
Currently, Vietnam’s ESRD care system faces three key structural constraints.
First, the system relies heavily on HD, which accounts for about 80% of dialysis services. In 2025, around 43,000 patients nationwide received renal replacement therapy, yet capacity was concentrated in approximately 430 HD centers, compared to about 60 PD centers and 31 kidney transplant centers. This imbalance places pressure on hospitals, healthcare personnel and infrastructure.
Second, there are significant geographic access barriers. Although around 61% of the population lives outside major cities, most dialysis services are located in urban areas. This limits access for patients in rural and remote regions, potentially leading to delayed treatment and poorer outcomes.
Third, the uptake of alternative therapies remains limited. The absence of reimbursement for certain outpatient medical consumables and incomplete health insurance coverage for consultations, patient education and outpatient care management reduce providers’ ability to introduce and sustain PD programs. As PD requires ongoing education and regular follow-up to ensure safe home-based care, limited financial support can weaken monitoring systems. As a result, adoption of PD remains relatively low despite its availability.
Drawing on Vantive’s global and regional experience, particularly Thailand’s long-standing “PD First” policy, why is home dialysis considered a strategic lever for reducing pressure on the healthcare system?
Thailand provides a relevant reference point. After evaluating a “PD-first” policy in 2004, the country formally implemented the policy in 2008 in a healthcare context that shared similarities with Vietnam, particularly in expanding access for rural and remote populations.
Driven by considerations such as cost efficiency, clinical outcomes and workforce capacity, the policy enabled Thailand to scale up renal replacement therapy, with nearly 70,000 patients treated, including about 34,000 on continuous ambulatory peritoneal dialysis (CAPD). Authorities estimated savings of approximately 8.3% in the national health insurance budget.
In 2022, Thailand introduced a “free choice” policy to expand access to HD and reduce patients’ out-of-pocket costs. However, this shift led to workforce constraints and challenges in maintaining HD quality, along with increased healthcare spending compared with the earlier “PD-first” period.
Following an impact assessment by the Health Intervention and Technology Assessment Program (HITAP), the Thai government reinstated the “PD-first” policy in April 2025, reflecting a reassessment of its role in balancing access, quality and cost control.
Please clarify the clinical outcomes and quality control mechanisms when patients use automated peritoneal dialysis (APD) supported by remote patient management (RPM).
Home Dialysis allows patients to perform dialysis at home, reducing the need for frequent hospital visits and enabling them to better maintain daily routines, employment and family life.
Published evidence, including studies such as Peritoneal Dialysis in the Modern Eraindicates that patients receiving PD often report higher levels of autonomy and lower anxiety compared to in-center HD, contributing to improved quality of life.
Clinically, approximately 80% of ESRD patients are considered suitable candidates for PD. With appropriate management, PD can provide outcomes comparable to HD, while preserving residual renal function, reducing hospitalization rates and serving as a bridge to kidney transplantation.
In pediatric cases, reduced hospital visits may help ease caregiver burden and lower risks associated with disrupted care. When combined with digital tools such as remote patient monitoring, APD enables healthcare providers to track adherence and key clinical parameters, identify early signs of complications and intervene in a timely manner.
To scale up home-based PD over the next five years, which elements of Vietnam’s national kidney care policy framework could be strengthened to support wider access and sustained patient adherence?
Sustaining home dialysis requires several key elements.
A comprehensive reimbursement framework that adequately covers peritoneal dialysis pathways is important to ensure patient access to advanced therapies and to support healthcare teams in delivering consistent care.
Coordination across the healthcare ecosystem is also critical. Public-private partnerships among government agencies, healthcare providers and private-sector stakeholders can help develop a scalable, patient-centered system. This may include standardized training programs, shared protocols for patient education and follow-up, and digital monitoring tools to maintain treatment quality and adherence.
Regional experience suggests that clear governance, defined clinical standards, workforce development and quality oversight are central to scaling home dialysis effectively. Private partners can contribute through capacity building, innovation and supply chain support, including reliable home delivery of home dialysis supplies to patients in remote areas and data-sharing mechanisms to reduce the risk of shortages or treatment interruptions.
How does Vantive commit to working alongside Vietnam’s healthcare system to help build a sustainable kidney care ecosystem?
Vantive states that its approach is guided by a patient-centered strategy focused on both clinical needs and long-term system sustainability, with three main priorities.
First, the company positions itself as a long-term partner by introducing therapies while also sharing global and regional expertise to support the development of an equitable kidney care system.
Second, it seeks to strengthen public-private collaboration to expand patient access, particularly through the adoption of home dialysis. This includes working with central and provincial hospitals to support standardized training and patient education programs.
Third, Vantive emphasizes digital infrastructure, including remote patient management and electronic medical records, to enable data-driven care, improve coordination and support treatment continuity.
According to the company, expanding home dialysis represents an important step toward improving access to care for kidney patients in Vietnam while supporting broader healthcare system resilience.
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