Alignment of Vietnam’s national Essential Medicines List with cancer incidence and the WHO EML.

Abstract

e23052 Background: Essential Medicines Lists (EMLs) are key policy instruments for ensuring equitable access to cancer treatment. We assessed whether the Vietnam National EML (nEML) aligns with the country’s cancer burden, and the World Health Organization (WHO) EML. Methods: Cancer medicines and indications were extracted from the 2023 WHO EML, matched to Vietnam’s national cancer incidence using GLOBOCAN 2022 data, and then compared to medicines listed on Vietnams’ nEML. Recognizing that most patients in Vietnam present with incurable disease, we assume all incident cases have a potential indication for treatment. We quantified the proportion of patients in Vietnam that could be treated if all nEML listed medicines were available. We then estimated the proportion of patients with at least one available NCCN preferred regimen based on the nEML. Our analysis focused on the top 10 incident cancers in Vietnam, and selected cancers of policy relevance (cervical cancer, testicular cancer, Hodgkin and non-Hodgkin lymphoma). Results: Of 65 cancer drugs listed in the WHO EML, 29 (44.6%) were included in Vietnams’ nEML, while one non–WHO EML drug (mitomycin) was included. Among the top 10 incident cancers in Vietnam, no nEML drugs were listed for liver or thyroid cancer where systemic therapies have limited therapeutic benefit. Paclitaxel and capecitabine, two drugs with potential indications in more than 40% of patients with cancer, are not listed on the Vietnam nEML. Among drugs with potential indications in > 10% and > 5% of patients with cancer, 9/20 (45.0%) and 15/28 (53.6%) were listed on the nEML, respectively. Among the top 10 cancers and 4 cancers of special interest, only 5/14 (35.7%) had all drugs for at least one NCCN preferred first-line regimen included in the nEML. Conclusions: A substantial gap exists between Vietnam’s nEML and the national cancer burden. The current nEML only supports a minority of NCCN preferred first line regimens for common cancers in Vietnam. We identified several low-cost drugs that could potentially benefit a large proportion of the population and should be considered in future iterations of Vietnam’s nEML.