Availability and reimbursement of systemic therapies for the five most common cancers in Vietnam: A national landscape analysis.

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Background: Access to evidence-based systemic anticancer therapies remains uneven in many low- and middle-income countries. Vietnam faces a rising cancer burden, with breast, lung, colorectal, hepatocellular (HCC), and gastric cancers representing the five most common malignancies according to GLOBOCAN 2022. We therefore aimed to systematically assess the regulatory approval and national health insurance reimbursement status of systemic therapies recommended for these cancers in Vietnam. Methods: We performed a cross-sectional analysis of systemic anticancer drugs recommended in the latest National Comprehensive Cancer Network (NCCN) guidelines as of February 2026 for five common cancers. Regulatory and policy data were retrieved at the same time point via the official websites of the governmental regulatory authorities. Drugs were classified as chemotherapy, endocrine therapy, targeted therapy, immune checkpoint inhibitors, or antibody–drug conjugates (ADCs). For each drug, we assessed marketing authorization status, availability via import license only, and actual commercial availability. Reimbursement was assessed by cancer type and treatment intent. Results: A total of 112 systemic therapies were identified. Overall, 60 (54%) had marketing authorization, 2 (2%) were available via import license only, and 57 (51%) were available at least in one hospital in Vietnam. Detailed figures by cancer type are presented in Table 1. Chemotherapy showed the highest availability (88%), followed by endocrine therapy (80%), whereas targeted agents, immune checkpoint inhibitors and ADCs ranged from 34–40%. Among available drugs, reimbursement rates varied by cancer type and treatment intent: 70–75% in breast cancer, 63–64% in lung, 56–57% in gastric, minimal in HCC, and in colorectal cancer 100% in curative versus 38% in metastatic disease. Conclusions: This study demonstrates measurable gaps between international guideline recommendations and the availability and reimbursement of systemic therapies in Vietnam, particularly for targeted agents, immunotherapy, and ADCs. Variability in regulatory approval and insurance coverage may contribute to differences in access across cancer types and treatment settings. These findings may inform future policy discussions on optimizing regulatory processes and reimbursement frameworks to enhance equitable access to cancer treatment.

Regulatory status and availability of recommended systemic therapies in Vietnam.