The Ministry of Health and Sports, WHO and the World Hepatitis Alliance (WHA) jointly convened a dialogue on Innovative Financing for the Viral Hepatitis Programme in Mongolia on 4-5 May with participation of the staff from related ministries, members of international community, patient and civil society organizations. The participants explored several existing and potential options of financing diagnosis and treatment of patients with viral hepatitis.
The high price of these new, curative hepatitis C treatments that were recently registered and became available in Mongolia, inhibit access for most of patients with viral hepatitis. While inclusion of these medicines in the National Health Insurance Fund is fundamental to addressing the epidemic, the ongoing economic crisis in the country means further financing for hepatitis may be needed.
Experts viewed an excise tax on tobacco and alcohol as one feasible option, because both cause substantial health problems in Mongolia – alcohol itself worsens liver disease during hepatitis C infection and can result in premature death for those hepatitis C infected.
While concrete solutions for supporting financing of the viral hepatitis response are being developed, WHO is supporting the Ministry to understand the return on investment should hepatitis C treatment be subsided to same level as other diseases of public health concern in Mongolia. For every MNT invested in eliminating hepatitis C in Mongolia, 4.5 MNT will be returned to the economy, resulting in savings for individuals, and Mongolian society.
The hepatitis B vaccine was introduced to the country in 1991 and is a part of the National Immunization Programme with more than 99% of young children now being hepatitis B free as a consequence. Hepatitis C antiviral drugs have recently been registered in Mongolia and are sold at tired-prices compared with developed countries, ranging from $750 - $1200 per 3 month course. These medications cure hepatitis C in 95 – 99% of cases. Insurance subsidies can assist access to these medicines as many patients cannot afford buying these drugs on their own.
While insurance subsidy is important, lower drug prices will be a lesser burden on the health insurance budget. This requires increased competition from generic producers on the Mongolian market.
There are estimated 400,000 persons with chronic viral hepatitis in Mongolia, a country with about 3 million population. Mongolia leads the world in liver cancer deaths.
The participants of the dialogue expressed a hope that Mongolia can become a leading country in devising meaningful solutions to affordable financing mechanisms for those suffering from the devastating consequences of hepatitis.