The Bhutanese Leading the way.
The Ministry of Health (MoH) is finalizing the Revised Ex-Country Referral Guidelines, 2nd Edition 2025, aiming to ensure that patients receive timely, safe, and high-quality treatment abroad while making efficient use of public resources.
“The purpose of this revision is to help patients get the best treatment possible and to make access to specialized care fairer for everyone,” said the MoH Minister, Tandin Wangchuk.
The proposed guidelines include expanding the age limit for kidney transplant recipients from 65 to 70 years, giving more patients on dialysis a chance for treatment.
Lyonpo Tandin Wangchuk also said the guidelines will introduce ABO-incompatible and swap kidney transplants to improve donor-recipient matches and reduce waiting times.
Advanced procedures such as bone marrow and stem cell transplants for blood cancers and immune disorders are also included, showing survival rates of 85 percent at one year, 65 percent at five years, and 58 percent beyond five years.
Liver transplants for non-alcoholic liver failure, as well as Transcatheter Aortic Valve Replacement (TAVR) for elderly patients aged 65-75 with aortic stenosis, are part of the updates.
The Daily Subsistence Allowance (DSA) for patients and attendants is proposed to be increased from Nu 150/125 to Nu 400, in line with the national minimum wage. “This will help families manage costs during referrals,” Lyonpo said.
The Minister emphasised that these are still proposals under review. Lyonpo Tandin Wangchuk said, “Our goal is to improve patient safety, raise treatment success rates, and make the referral process more effective and equitable.”
Data from the National Medical Services show that in Fiscal Year 2024–2025 there were 1,245 patients (637 female and 608 male) sent abroad for treatment, with a total expenditure of Nu 730 million. This comes to an average of Nu 586,345 per referral, slightly lower than previous estimates.
Lyonpo said that the proposed guidelines aim to ensure safer, timely, and more effective treatment for patients abroad.
