Cancer in Vietnam has evolved from a personal health issue to a societal problem that impacts family livelihoods and the national health insurance system. While targeted therapies and immunotherapies have improved survival rates, treatment costs have skyrocketed, reaching millions of dong. Each year, over 110,000 Vietnamese die from cancer, prompting local readers to express that "treatment costs are too high, leading patients to give up," while calling for improved food safety, early screening, and expanded insurance coverage.
According to local reports from VnExpress on August 5, the landscape of cancer treatment in Vietnam presents a dilemma: as medical advancements progress, so do the financial burdens. Recent cancer treatments utilize targeted therapies and immunotherapies, which focus on specific molecular mechanisms, unlike traditional chemotherapy. These methods selectively attack cancer cells, enhancing treatment efficacy and reducing side effects, thereby extending patients' survival.
The issue lies in the treatment costs. Nguyen Thi Thu Hang, Deputy Director of Ho Chi Minh City's Social Insurance, stated at a recent cancer prevention conference that the costs of various treatment protocols range from millions to tens of millions of dong. For instance, trastuzumab, used for HER2-positive breast cancer, costs approximately 800 million to 900 million dong (about $34,000 to $39,000) per patient per year, excluding testing, administration, and monitoring costs.
Immunotherapy is even more expensive. Pembrolizumab, used for lung, stomach, esophageal, and cervical cancers, exceeds 60 million dong (about $2,600) per vial. Depending on the treatment regimen, two vials may be needed per cycle, leading to costs exceeding 1 billion dong (about $43,000) if treatment lasts one to two years.
Vietnam's health insurance does not completely ignore high-cost cancer drugs. Some targeted therapies, such as bevacizumab, trastuzumab, rituximab, imatinib, and cetuximab, are covered by insurance. However, coverage rates vary between 30% and 70% based on the drug's components and indications, leaving patients to cover the remainder. The health insurance system spends approximately 20 trillion dong annually on cancer treatment.
The financial burden on Ho Chi Minh City is evident in the numbers. According to the city's social insurance statistics, the total health insurance expenditure last year was about 33 trillion dong (approximately $1.4 billion), with cancer treatment accounting for around 5 trillion dong (about $271 million). This means that about 17% of total expenditures are allocated to cancer care. In the first half of this year alone, health insurance covered 619,000 cancer treatment cases, amounting to 2.478 trillion dong (about $134 million).
Insurance funds flowing to major hospitals are also significant. Cho Ray Hospital receives about 4.5 trillion dong annually, while Ho Chi Minh City Oncology Hospital and Ho Chi Minh City University of Medicine and Pharmacy Hospital each receive close to 2 trillion dong.
However, even with insurance, patients still face substantial out-of-pocket expenses. Some targeted therapies are partially covered, requiring patients to pay an additional 50 million to 60 million dong monthly to continue treatment. This amount far exceeds what an average Vietnamese family can afford. Some new drugs that have been in use in other countries for 5 to 10 years have yet to be included in Vietnam's reimbursement list. Wealthy patients can pay for their medications in full, but those without financial means miss out on treatment opportunities.
The increasing number of patients also pressures the insurance system. Nguyen Thi Thu Hang noted that the number of cancer patients in Ho Chi Minh City is projected to rise from approximately 337,000 in 2024 to 378,000 in 2025, an annual increase of about 12%. In addition to drug costs, expenses for tests, imaging diagnostics, surgeries, radiation therapy, and long-term follow-ups contribute to the financial strain on the health insurance fund. Currently, the health insurance premium rate is typically 4.5% of the basic salary or contracted salary, with a maximum of 6%. Last year, Ho Chi Minh City exceeded its health insurance expenditure budget by over 1 trillion dong.
Vietnam's Cancer Crisis in Numbers: Late Detection More Alarming Than High Costs
Another aspect of Vietnam's cancer issue is the high mortality rate. According to GLOBOCAN 2024 data from the International Agency for Research on Cancer (IARC), Vietnam sees 177,404 new cancer cases each year, with 111,015 deaths from the disease. Currently, 404,153 patients are living with cancer within five years of diagnosis. This translates to nearly one person dying from cancer every five minutes. Over the past 16 years, new cancer cases have increased by 59%, and the mortality rate has risen by about 35%. Dr. Do Anh Tu, Deputy Director of K Hospital and Secretary of the Vietnam Cancer Society, warned at a seminar hosted by Tien Phong Newspaper on July 31 that "without early intervention, these numbers could rise sharply.
Experts view the ratio of deaths to new patients as an indicator of the efficiency of the diagnostic and treatment system. In Vietnam, approximately 63% of the 177,404 new cases result in death, compared to 35% to 40% in developed countries like the United States, the United Kingdom, and Japan. The significant gap is primarily due to late diagnoses, as many patients seek medical attention only after their tumors have metastasized.
A shortage of medical personnel also hampers progress. Local experts point out a lack of internists, oncologists, radiation therapists, and especially pathologists. Cancer registration data is concentrated in a few facilities, lacking a nationwide connected system. While developed countries can quickly adapt strategies based on national cancer registration systems, Vietnam lacks this foundation, making it difficult to establish accurate policy directions.
Online reactions from Vietnamese netizens have focused on the burden of treatment costs and environmental issues. One reader expressed hope that "Vietnamese factories are strengthening research and production of cancer treatments, so the pressure will gradually decrease," while another questioned, "When will a vaccine that prevents all cancers be available?" Conversely, some noted, "Many patients give up on treatment because costs are too high and unaffordable, with no guarantee of a cure."
Another commenter lamented, "The burden on families and society is immense," stating that they must care for patients until recovery or death while also managing treatment costs. They urged health authorities to strengthen food safety management and called for educational authorities to include health management knowledge in school curricula from elementary levels. "Food safety is paramount, and a clean or less polluted living environment is second," they emphasized, criticizing that these two issues remain merely on paper.
* This article has been translated by AI.
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