Medicine prices, availability, and affordability in Vietnam

Objective: To assess the price, availability and affordability of a sample of medicines in Vietnam. Methods: Data on the price and availability of 42 medicines were collected using the standard World Health Organization/Health Action International (WHO/HAI) methodology in five geographical areas in Vietnam. The median price of these medicines was compared with the Management Science for Health international reference prices (IRPs), expressed as median price ratios. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase one course of therapy. Of the 42 medicines studied, 15 were chosen for international comparison, which were included in at least 80% of other country surveys using the WHO/HAI methodology. Results: Public sector availability of generic medicines was 33.6%. The median public procurement price was 1.82 times the IRPs for generics, but for some individual medicines it was less than half the IRP. The price to patients in public outlets was higher than in private pharmacies. Adjusted for Purchasing Power Parity in 2005, the lowest generic prices in private pharmacies were still 8.3 times the IRPs. Treatments were thus unaffordable for a large part of Vietnam’s population. Conclusions: Medicines in Vietnam were high in price, and low in both availability and affordability, especially in the public sector. To make public facilities a primary treatment option for the poor, Vietnam must reduce medicine prices in this sector by improving procurement efficiency, ensuring and promoting low-priced generics, and regulating reasonable mark-ups.