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Drug pricing and reimbursement decision making systems in Mongolia
Article Number: SIS869123AI231222
23rd December, 2022
Author(s):
Gereltuya Dorj, Bruce Sunderland, Tsetsegmaa Sanjjav, Gantuya Dorj, Byambatsogt Gendenragchaa
Abstract:
Background: It is essential to allocate available resources equitably in order to ensure accessibility and affordability
of essential medicines, especially in less fortunate nations with limited health funding. Currently, transparent and
evidence based research is required to evaluate decision making regarding drug registration, drug pricing and
reimbursement processes in Mongolia.
Objective: To assess the drug reimbursement system and discuss challenges faced by policy-makers and stakeholders.
Methods: The study has examined Mongolian administrative documents and directives for stakeholders and analysed
published statistics. Experts and decision-makers were interviewed about the drug pricing and reimbursement
processes in Mongolia.
Results: Decisions regarding Mongolian drug registration were based on commonly used criteria of quality,
safety, efficacy plus some economic considerations. A total of 11.32 billion Mongolian National Tugrugs (MNT)
[5.6 million United States Dollars (USD)] or 12.1% of total health expenditure was spent on patient reimbursement of
essential drugs. The highest reimbursed drugs with respect to cost in 2014 were the cardiovascular drug group. Health
insurance is compulsory for all citizens; in addition all insured patients have access to reimbursed drugs. However, the
decision making process, in particular the level of reimbursement was limited by various barriers, including lack of
evidence based data regarding efficacy and comparative cost-effectiveness analysis of drugs and decisions
regarding reimbursement.
Conclusions: Drug registration, pricing and reimbursement process in Mongolia show an increasing trend of
drug registration and reimbursement rates, along with lack of transparency. Limited available data indicate that
more evidence-based research studies are required in Mongolia to evaluate and improve the effectiveness of
drug pricing and reimbursement policies.