Cancer is the biggest healthcare burden in Vietnam. According to the World Health Organization (WHO), in 2022, Vietnam recorded more than 180,000 new cases, while the figure is predicted to rise to 222,000 cases by 2030. Treatment costs, especially for biologic drugs such as trastuzumab, bevacizumab, and rituximab, account for a large proportion of the health insurance budget. In 2024, the fund paid over VND8,500 billion for cancer drugs, ranking second in total drug payments.

Cancer, along with other non-communicable diseases, creates ripple effects: increased healthcare costs, reduced labor productivity, and impact on socio-economic developments and politics.

Amid limited healthcare budgets, biosimilar drugs have emerged as a strategic solution as they can reduce 13-30 percent costs compared to originators, maintain equivalent efficacy and safety, and help expand treatment access for millions of patients.

70% of cancer patients in financial crisis

At a recent conference in Hanoi, Level-II Specialist, Doctor Vu Dinh Tien, Deputy Director of K Hospital (Hanoi), reported on the reality of Vietnam's cancer drug market. Traditional chemotherapy drugs are mostly available, and the health insurance fund covers 80-100 percent costs, ensuring wide access.

Meanwhile, advanced therapies (targeted and immunotherapy) cost 40–50 times the average annual income per capita (around $4,500 per year), meaning only a small number of patients can afford them. High cost remains the biggest barrier.

Among these expenses, biologic drugs account for the largest share, especially those used for cancer and immune regulation, of which bevacizumab (15.77 percent) and trastuzumab (15.15 percent) are the two drugs with the highest health insurance reimbursement rates.

Because of high treatment costs, nearly 70 percent of Vietnamese cancer patients fall into financial crisis after just one year of treatment, the highest rate among low- and middle-income countries in ASEAN.

Patients in rural areas face serious difficulties in accessing medicines and specialized treatment facilities.

According to Dr Ong The Due from the Institute of Health Strategy and Policy (Ministry of Health), over the past two decades, the average price of cancer drugs has increased from $12,000 to more than $120,000 per year, with some advanced therapies like CAR T-cell costing up to $500,000 (VND12-13 billion). 

Also according to Dr Due, current healthcare spending in Vietnam is rising rapidly, from $17.4 billion (2019) to $25.6 billion (2023) and projected to reach $34.1 billion by 2028. Drug costs account for 25–28 percent of total health expenditure, equivalent to $6.6 billion (2023), expected to rise to $8.6 billion by 2028.

With health insurance coverage reaching 93.35 percent of the population (2023), the health insurance fund spent VND121,221 billion, five times higher than in 2009. Drugs accounted for 33.8 percent of the spending structure, increasing from VND11.5 trillion (2010) to VND47.23 trillion (2023). However, the risk of exceeding spending ceilings still exists without risk-sharing mechanisms.

Cancer drugs account for 61.1 percent of treatment costs, in which originator drugs, despite only making up 3–4 percent in quantity, account for more than 30 percent of total spending. The cancer and immunomodulatory drug group ranks second in health insurance’s spending proportion. 

A new substitution 

Pharmacist Vu Dinh Tien emphasized that switching to biosimilar drugs not only saves money but also makes the health insurance fund sustainable, helping more patients access modern biologic therapy.

At K Hospital, replacing originator drugs with biosimilars saved VND274 billion in 2024.

European experience shows the usage rate of biosimilar drugs is increasing rapidly, currently saving about $6.5 billion/year and continuing to rise.

Globally, more and more biosimilar drugs are approved for cancer treatment. From 2026 to 2032, 39 high-revenue biologic drugs’ patent protection will expire, opening opportunities for reasonable cost access for Vietnamese patients.

To achieve this, Tien proposed four solutions.

First, strengthen training and communication for doctors, pharmacists about benefits, efficacy and safety of biosimilar drugs.

Second, organize centralized bidding with appropriate proportion for biosimilar drug group in public hospitals.

Third, improve pharmacovigilance system to closely monitor efficacy and safety after use.

Promote international cooperation to learn from countries that have successfully implemented like European countries, Korea, India.

Phuong Thuy