Vietnam
Regulatory liberalization inside a controlled political environment, carried by ministerial instruments rather than statute.
9 domains reviewed · 8 high-confidence · 2 dated estimates · 8 material gaps
WHO region: Western Pacific. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 0 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 12
- Sources behind this dossier
- 14
- Newest source 2026
Lessons from Vietnam
- Vietnam reformed regulation and trained prescribers together, with curricula written for the country, and morphine use rose every year. It is the clearest precedent in the register for pairing a training credential with a rule change.145,146
- A decade later, professionals and regulators still named restrictive pharmacy rules and missing pain policy as barriers, and most regulators had poor opioid knowledge. Regulators need training too.149
- Without insurance cover, community palliative care barely existed. Home care needs a payment line to exist at all.147
- Where dying at home is seen as essential for a good death, end-of-life support that reaches families at home fits local values better than hospital-based services alone.469
- Surveying regulators alongside clinicians showed that 80.0% of Vietnamese policymakers and regulators had poor knowledge of opioid therapy for cancer pain, so opioid training can include the people who write and enforce the rules.149
- A pediatric palliative consult service in a lower-middle-income country became high volume by partnering with hospital leadership and creating staff education opportunities.656
Palliative care
Is morphine available in Vietnam?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 0.00 DDD per 1,000 inhabitants per daySOURCE-CHECKED
Morphine consumption, Vietnam, 200570
Last checked 2026-09-24.
Cite this figure: - 0.01 DDD per 1,000 inhabitants per daySOURCE-CHECKED · 2014 DATA
Morphine consumption, Vietnam, 201470
Last checked 2026-09-24.
Morphine was the predominant strong opioid, unlike fentanyl in Malaysia and Indonesia.
Cite this figure:
Morphine consumption rose every year after the reforms, and morphine rather than fentanyl became the predominant strong opioid. National use remained far below regional leaders.70,146
How does Vietnam regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
- 10 daysSECONDARY SOURCE
Maximum opioid supply on one outpatient prescription, Vietnam, 200844
Last checked 2026-09-22.
Set by Decision 04/2008/QD-BYT. Three such prescriptions may be written for one indication, to a maximum of one month.
Cite this figure: - 7 daysSECONDARY SOURCE
Maximum supply on a prescription written at a home visit, Vietnam, 200844
Last checked 2026-09-22.
Applies to end-of-life cancer and AIDS patients staying at home.
Cite this figure: - 80 percentSOURCE-CHECKED
Policymakers and regulators with poor knowledge of opioids for cancer pain, Vietnam, 2022149
Last checked 2026-09-24.
63.3 percent of health professionals.
Cite this figure:
A sequence of Ministry of Health instruments rather than one reform: the national palliative care guideline for cancer and AIDS patients was promulgated by decision in 2006, outpatient opioid prescribing limits were set by decision in 2008, and a 2010 circular allowed retail pharmacies meeting Good Pharmacy Practice standards to dispense addictive drugs to outpatients. By 2022 professionals and regulators still named restrictive pharmacy dispensing rules and the absence of a national pain policy as major barriers.44,149
Did any later instrument change the prescribing day limits set in 2008?
Help answer it:Search PubMedWho can prescribe morphine in Vietnam?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
- 8 percentSOURCE-CHECKED · 2014 DATA
Physicians who felt adequately trained in palliative care before training, Vietnam, 2014148
Last checked 2026-09-24.
Survey of 2007 to 2014.
Cite this figure:
Prescribing remains with physicians. Training was extended to nurses, but no source reports nurses gaining authority to prescribe; the reform widened the dispensing channel, not prescriber scope.147,148
Has any instrument given nurses or pharmacists authority to prescribe opioids?
Help answer it:Search PubMedHow does palliative care reach patients in Vietnam?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 15 hospitalsSOURCE-CHECKED
Hospitals offering palliative care, Vietnam, 2010146
Last checked 2026-09-24.
Up from three at the start of the initiative.
Cite this figure:
The 2010 circular moved outpatient dispensing beyond the hospital, which the national situation report treats as the precondition for cancer patients holding opioids at home. Hospitals offering palliative care grew several-fold during the reform period.44,146
Who pays for palliative care in Vietnam?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Community-based palliative care was not covered by government health insurance and was therefore almost unavailable, and a project was testing whether insurance coverage of home care would pay off.147
Has health insurance since covered home palliative care or opioids?
Help answer it:Search PubMedHow are palliative care clinicians trained in Vietnam?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 400 physicians, lower boundSOURCE-CHECKED
Physicians trained in palliative care, Vietnam, 2010145
Last checked 2026-09-24.
Reported as more than 400 by early 2010.
Cite this figure:
Training was built into the reform from the start, using curricula written for Vietnam with the ministry, hospitals and universities, and controlled evaluation showed durable gains in knowledge.145,148
Is training a legal condition of prescribing, and is there a recognised credential?
Help answer it:Search PubMedHow does Vietnam prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Clinicians, regulators and patients described limited oral morphine, hard-to-obtain certifications of continued need and overly strict enforcement blocking cancer pain relief; proposed fixes included oral morphine at district level and an electronic prescription monitoring system. In a 2022 survey, 32.4% named excessively restrictive pharmacy dispensing as a major barrier. Community methadone treatment was linked to larger drops in heroin use than compulsory detention.471,149,653
Has Vietnam adopted electronic opioid prescription monitoring, and is naloxone available in communities or only in hospitals?
Help answer it:Search PubMedHow do children get palliative care in Vietnam?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Vietnam's first pediatric palliative program opened in 2017 at a major children's hospital. In 18 months its consult service saw 169 children aged 0 to 15.6 years, with psychosocial support the most common intervention (70%) and pain management given to 28%.656
Are child-appropriate oral morphine formulations and pediatric palliative services available outside the major children's hospitals?
Help answer it:Search PubMedHospice care in Vietnam
How the hospice model works here, who can use it, who pays and who it reaches. Covered 0 of 4.
What does hospice care look like in Vietnam?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Does Vietnam have any freestanding or inpatient hospice units, and who runs them? PubMed literature found here describes hospital palliative care departments and one cancer center home care team, and does not describe hospice as a distinct service.
Help answer it:Search PubMedWho can get hospice care in Vietnam?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
What criteria (diagnosis, prognosis, referral route) govern entry to end-of-life home or inpatient care in Vietnam, and how close to death are patients referred?
Help answer it:Search PubMedWho pays for hospice care in Vietnam?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Does Vietnam Social Security or any charity fund hospice-type end-of-life care, as distinct from hospital palliative care?
Help answer it:Search PubMedHow many people reach hospice in Vietnam?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
How many hospice-type services exist in Vietnam, and what share of dying patients use them, including children and non-cancer patients?
Help answer it:Search PubMedWhat fills the gap in Vietnam
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
Across interviews in Hanoi, Ho Chi Minh City and Dak Lak, a good death was usually described as dying at home surrounded by family. Families keep at least one member beside the dying person, and dying outside the home is linked to the belief that the spirit becomes a wandering soul. Where specialist services exist mainly in major cities, the family becomes the main caregiver at the end of life.469
Subnational evidence- Traditional and complementary healers
In a survey of 658 patients with non-communicable diseases at two tertiary facilities, 48.6% reported current herbal medicine use and 96% of users had not told their healthcare providers. Potential herb-drug interactions were flagged for 31.3% of users.470
Subnational evidence- Substitute and informal pain relief
Interviews with 17 providers, patients, caregivers and regulators described limited oral morphine availability, strict regulation, fear of addiction and the association of morphine with impending death. Scarce palliative and home care services added to these barriers, and the study title quotes the phrase "I wait for leftover morphine".471
Sources cited here
- 70Zin CS.
Ten years of strong opioid analgesics consumption in Malaysia and other Southeast Asian countries. Journal of Pharmacy and Bioallied Sciences 2020;12(Suppl 2):S846-S851. DOI 10.4103/jpbs.JPBS_252_19. Strong opioid consumption from 2005 to 2014 in defined daily doses per 1,000 inhabitants per day, from Pain and Policy Studies Group data drawing on INCB reports; fentanyl, then pethidine, then morphine in Indonesia.
- 146Krakauer EL, Nguyen TPC, Husain SA, Nguyen THY, Joranson DE, Luong NK, et al.
Toward safe accessibility of opioid pain medicines in Vietnam and other developing countries: a balanced policy method. Journal of Pain and Symptom Management 2015;49(5):916-922. DOI 10.1016/j.jpainsymman.2014.10.012. Abstract read. Morphine consumption rose every year and the number of hospitals offering palliative care grew after the balanced policy reforms.
- 44Pham Thi Hoang Anh, Ngo Thi Thanh Thuy, Trinh Huu Vach, et al.
Report on current situation of palliative care service provision for cancer patients in Vietnam. HealthBridge Foundation of Canada with the Research Center for Rural Population and Health, Hanoi, August 2010. Quotes the operative Ministry of Health instruments: Decision 3483/QD-BYT of 15 June 2006 promulgating the national palliative care guideline for cancer and AIDS patients; Decision 04/2008/QD-BYT of 1 February 2008 setting outpatient opioid prescribing limits; and Circular 10/2010/TT-BYT of 29 April 2010, whose Article 14 permits retail pharmacies meeting Good Pharmacy Practice standards to dispense addictive drugs to outpatients.
- 149Nguyen T, Dam A, Nguyen D, Tran P, Truong NLT, Nguyen H, et al.
Opioid therapy for cancer pain in Vietnam: knowledge, attitudes, and perceived barriers among health care professionals, policymakers, and regulators. JCO Global Oncology 2024;10:e2300463. DOI 10.1200/GO.23.00463. Abstract read. Survey in 2022: poor opioid knowledge among professionals and regulators; barriers include no national pain policy, inadequate training and excessively restrictive pharmacy dispensing rules.
- 147Krakauer EL, Thinh DHQ, Khanh QT, Huyen HTM, Tuan TD, The THN, et al.
Palliative care in Vietnam: long-term partnerships yield increasing access. Journal of Pain and Symptom Management 2018;55(2S):S92-S95. DOI 10.1016/j.jpainsymman.2017.03.038. Abstract read. Training extended to physicians and nurses; community-based palliative care not covered by government health insurance and therefore almost unavailable; a project testing insurance coverage of home care.
- 148Tsao L, Slater SE, Doyle KP, Cuong DD, Khanh QT, Maurer R, et al.
Palliative care-related knowledge, attitudes, and self-assessment among physicians in Vietnam. Journal of Pain and Symptom Management 2019;58(6):1015-1022.e10. DOI 10.1016/j.jpainsymman.2019.08.001. Abstract read. Baseline survey of physicians before training, 2007 to 2014: few felt adequately trained, most had prescribed an opioid, and most reported restrictions on morphine.
- 145Krakauer EL, Cham NTP, Khue LN.
Vietnam's palliative care initiative: successes and challenges in the first five years. Journal of Pain and Symptom Management 2010;40(1):27-30. DOI 10.1016/j.jpainsymman.2010.04.009. Abstract read. A 2005 situation analysis, 2006 national guidelines, 2008 revised opioid prescribing regulations, and palliative care training for physicians using curricula written for Vietnam.
- 471Nguyen T, Dam A, Bui L, et al.
I Wait for Leftover Morphine: A Qualitative Study of Barriers to Safe Opioid Access for Cancer Pain Relief in Vietnam. JCO Glob Oncol 2025;11:e2500026. Interviews with 17 providers, patients/caregivers and regulators on barriers to opioid access; small purposive sample. Abstract read.
- 653Vuong T, Ritter A, Shanahan M, et al.
Outcomes of compulsory detention compared to community-based voluntary methadone maintenance treatment in Vietnam. J Subst Abuse Treat 2018;87:9-15. Observational comparison of 208 people in compulsory centers and 384 in community methadone treatment, 2012 to 2014; not palliative care specific. Abstract read.
- 654Mai T, Trinh O, Do D, et al.
Health outcomes of cancer patients during the first year following admission to palliative care: A longitudinal study in Ho Chi Minh City, Vietnam. Medicine (Baltimore) 2026;105(29):e49840. Longitudinal study of 134 patients and their caregivers at one tertiary oncology hospital, 2020 to 2022; single-site. Abstract read.
- 655Ho XD, Duong NT, Phan MT
Vietnamese family members perception of palliative sedation at the end of life. J Psychosoc Oncol 2026:1-16. Cross-sectional survey of 100 relatives of end-stage cancer patients in central Vietnam; authors are also affiliated with a local NGO (Raising Hope Organization). Abstract read.
- 656Adelmann MR, Bui HTT, Hocaoglu M, et al.
Implementing Pediatric Palliative Care in Vietnam: Initial Experiences and Lessons. J Pain Symptom Manage 2025;71(3):341-350.e3. Retrospective review of 169 children seen by Vietnam's first pediatric palliative consult service over 18 months; single-site self-evaluation by the program team. Abstract read.
- 469Doan NP, Le Thao MN, Phuoc AL, et al.
Perceptions of death, dying and the body in Vietnamese culture: A qualitative exploration from a study examining the potentials of minimally invasive tissue sampling in Vietnam. SSM Qual Res Health 2026;9:100714. Qualitative study (59 interviews, five focus groups) in Hanoi, Ho Chi Minh City and Dak Lak describing home death, family presence and post-death rituals; framed around tissue sampling acceptability, with only two Ede minority participants. Full text read.
- 470Phan ADT, Vo TH, Luu TNN, et al.
Herbal medicine use disclosure, database-flagged potential herb-drug interactions, and inter-interaction database concordance among patients with non-communicable diseases in Vietnam: A multicenter cross-sectional study. PLoS One 2026;21(7):e0355046. Survey of 658 patients with non-communicable diseases at two tertiary facilities on herbal medicine use and disclosure; not specific to end of life. Abstract read.