Rising costs caused by multiple intermediaries in the supply chain, combined with persistent procurement hurdles at public hospitals, are prompting calls for greater price transparency, legal reforms, and increased autonomy for healthcare providers to better protect patients' interests.
Patients struggle to access diagnostic services
After being diagnosed with rectal cancer in early 2026, a 67-year-old HCMC resident underwent surgery and follow-up treatment. During a subsequent examination, doctors detected a lesion near the surgical site that appeared to be growing and recommended a PET/CT scan to assess the condition.
However, due to a shortage of radiopharmaceuticals, he had to travel to Hanoi for the scan.
Many cancer patients from Ho Chi Minh City and southern provinces have likewise been forced to travel to Hanoi or Da Nang for PET/CT scans, despite hospitals in the region already having the necessary equipment. The reason is a disruption in radiopharmaceutical supplies, while the production system at Cho Ray Hospital has deteriorated and cannot yet be replaced because of procurement and bidding obstacles.
Hospitals in Hanoi are also facing difficulties replacing outdated equipment. At Hanoi Oncology Hospital, several key systems, including a 64-slice CT scanner, a 1.5-Tesla MRI machine, angiography systems, and linear accelerators, have fully depreciated since 2025 and require repairs and maintenance. Replacement investments have yet to be made because of procurement procedures.
During a National Assembly group discussion on Oct. 21, Prime Minister Le Minh Hung highlighted shortcomings in the management and procurement of medicines and medical equipment that are increasing treatment costs and directly affecting patients.
Inspections, audits, and investigations have uncovered cases in which businesses established overseas companies and conducted transactions through multiple intermediary layers to inflate prices before importing goods into Vietnam.
The Prime Minister instructed the health sector to urgently amend problematic regulations, reduce unnecessary intermediaries, and ensure hospitals and patients can access medicines and medical equipment at reasonable prices.
Pilot procurement mechanism proposed
According to Associate Professor Pham Khanh Phong Lan, Chairwoman of the HCMC Pharmaceutical Association, difficulties in procuring medical equipment have not been fundamentally resolved despite amendments to the Bidding Law and related regulations.
"The tighter the procedures, the harder it becomes to attract suppliers, but that does not necessarily prevent misconduct," she said.
Ms. Pham Khanh Phong Lan proposed piloting new procurement mechanisms at selected hospitals, potentially through price appraisal councils or negotiated procurement processes to identify suitable equipment. Hospitals should be granted greater autonomy while remaining accountable for purchase prices, usage needs, and equipment efficiency.
Associate Professor Nguyen Vu Trung, director of the Pasteur Institute in HCMC, said drug prices should be monitored throughout the entire supply chain, from importation and distribution to retail sales, while unnecessary intermediaries should be eliminated to prevent excessive markups.
At the same time, he stressed the need to maintain reasonable profit margins and properly account for storage, transportation, warehousing, and operational costs to avoid pricing policies that could disrupt supply.
Procurement decisions should also fully incorporate warranty, maintenance, and repair costs throughout an equipment's life cycle. A low purchase price does not necessarily mean lower overall costs if equipment operates inefficiently or breaks down frequently, he said.
Ultimately, the key measure should be effective use of public funds and the quality of services provided to patients.
Director Nguyen Minh Loi of the Department of Medical Infrastructure and Equipment under the Ministry of Health said the ministry is studying a life-cycle approach to medical equipment price management. The model would take into account operating, maintenance, repair, replacement-part, and consumable costs rather than focusing solely on the initial purchase price.
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