Vietnam Health Ministry to Expand 90-Day Prescription List for Chronic Diseases

Expanding Chronic Disease Coverage to 370 Conditions

Under the current implementation of Circular 26/2025, numerous provincial health departments and major hospitals reported significant operational hurdles. Because this specific code was omitted from the initial catalog, patients prescribed 90-day supplies of cardiovascular medications still had to return monthly solely to renew prescriptions for cholesterol-lowering drugs.

Similarly, Bach Mai Hospital in Hanoi reported that chronic obstructive pulmonary disease (COPD)—identified by code J44 and affecting an estimated 10% of the population, or roughly 10 million people—was excluded from the 90-day prescription program.

To resolve these bottlenecks, the revised draft circular incorporates 118 new disease codes into the extended prescription framework. Cardiovascular conditions account for the largest share with 46 new additions, including heart failure, atrial fibrillation, atherosclerosis, congenital heart defects, and venous insufficiency. The skin and subcutaneous tissue category adds 34 conditions such as cutaneous lupus erythematosus, acne, alopecia areata, vitiligo, and keloids. Additionally, endocrine, nutritional, and metabolic groups add six new entries, including prediabetes, dyslipidemia, and diabetes insipidus.

Managing Coexisting Chronic Conditions

Elderly patients and individuals with primary chronic ailments like hypertension and diabetes frequently live with stable secondary conditions. Health departments in Ho Chi Minh City, Hai Phong, and Vinh Long previously noted that if a primary diagnosis qualifies for a 90-day prescription while a comorbid condition is restricted to 30 days, patients are still forced into frequent follow-up appointments.

In response to these regional feedbacks, the Ministry of Health's new draft authorizes physicians to evaluate clinical conditions and prescribe treatments for diagnosed, stable chronic comorbidities for up to 90 days concurrently with the primary disease. The agency stated that a three-month cycle represents the optimal interval for clinicians to re-examine biochemical indicators, liver and kidney function, and blood pressure to safely adjust dosages and prevent complications.

Flexibility in Multidisciplinary Prescriptions

The previous requirement under Circular 26/2025 to consolidate all specialized medication orders into a single unified prescription generated legal and technical complications for clinical staff.

To alleviate these administrative roadblocks, the updated draft grants healthcare providers the flexibility to issue prescriptions either through specific medical specialties or via a single general prescription. Concurrently, medical facilities remain strictly responsible for monitoring contraindications, drug interactions, and duplicate therapies across specialties to safeguard patient health.