title: Drug pricing and reimbursement decision making systems in Mongolia.
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.
authors.affiliation: Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy and Biomedicine, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia.
authors.forename: Gereltuya
authors.initials: G
authors.lastname: Dorj
authors.affiliation: School of Pharmacy, Faculty of Health Sciences, Curtin University of Technology, WA Perth, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Sunderland
authors.affiliation: School of Pharmacy and Biomedicine, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia.
authors.forename: Tsetsegmaa
authors.initials: T
authors.lastname: Sanjjav
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia.
authors.forename: Gantuya
authors.initials: G
authors.lastname: Dorj
authors.affiliation: ISPOR Chapter Mongolia, Bayanzurkh district, 76-26, 13374 Ulaanbaatar, Mongolia.
authors.forename: Byambatsogt
authors.initials: B
authors.lastname: Gendenragchaa
keywords: Cost; Drug pricing policy; Mongolia; Pharmaceuticals; Reimbursement