Country of origin and prices of systemic antibiotics in Vietnam: a multicentre retrospective study.

Background: Local production of antibiotics is essential for improving access to treatment of clinical infection and avoiding vulnerability to expensive drug imports. Objectives: To describe the country of origin and cost of antibiotics in Vietnam. Methods: This was an observational study. Antibiotic procurement in 372 healthcare facilities in Vietnam between 2018 and 2022 were included in this analysis. Antibiotics were classified using the Anatomical Therapeutic Chemical Index and the 2021 WHO Access, Watch and Reserve groups. The country of origin of antibiotics was determined by the place where the final products were manufactured. Antibiotic costs were estimated in US dollars per DDD and adjusted by annual inflation. Results: This study included 2.54 billion antibiotic DDDs, totalling 3.13 billion US dollars. Local production accounted for 80.2% of the number of DDDs and 43.4% of the total expenditure. The antibiotics from other countries were driven by imports from high-income countries, which accounted for 75.5% of DDDs and 89.6% of the expenditure on imported antibiotics. Availability of Reserve group antibiotics was more dependent on imports from high-income countries (36.6% of DDDs) than those of Access (15.7% of DDDs) and Watch group antibiotics (14.2% of DDDs). Conclusions: A comprehensive policy approach is needed to ensure the affordability and to reduce dependency on imported Reserve group antibiotics.