Current Market Trends
Procurement & Tenders
Population: 3.2 million (2018)
GDP: $12 billion (2017)
Mongolia is transitioning to a more Western-based healthcare model from a socialist-era health system characterized by government control, emphasis on inpatient care, and lack of well-trained medical professionals and high-quality equipment.
Mongolia’s healthcare market offers a range of providers, including public and private pharmacies, hospitals, and medical professional services. The highest quality healthcare services are available in Mongolia’s urban areas, particularly in the capital city of Ulaanbaatar. Mongolia has over 4,005 health-related facilities nationwide, including 91 public hospitals, and more than 240 inpatient private hospitals, 1,226 out-patient clinics, and 1,277 private pharmacies. In addition, Mongolia allows three foreign-operated clinics to provide health services in Ulaanbaatar, but bars these clinics from conducting surgical procedures.
The Mongolian government, the dominant provider, delivers healthcare through three levels of service: primary, secondary, and tertiary. At the primary level, the government covers 100% of the costs for a basic package of services for rural and urban residents; at the secondary level, the state covers 90% and citizens pay a 10% copayment; and at the tertiary level, citizens pay a 15% copayment. Private medical services reputedly offering higher levels of care than the state-run system are also available.
Mongolia’s best medical facilities, the tertiary level facilities, are in Ulaanbaatar and include specialized hospitals and centers for cancer treatment, maternity care, psychiatric care, and infectious disease response. Generally adequate, these facilities fall short of Western standards of care. Mongolia also has informal health providers, including traditional healers, vendors selling medication from shops or markets, and midwives. Over the past decade, respiratory system diseases, digestive system diseases, circulatory system diseases, urinary tract diseases, and accidents and injuries have been the leading causes of morbidity and mortality.
High-income and some middle-income citizens seek medical treatment abroad for both elective and emergency treatment, primarily in South Korea, Thailand, and China.
The current Mongolian government has publicly committed to improving the health sector. Priorities include doubling the government’s budget for the health sector over the next four years, improving the accessibility and quality of healthcare services, and training additional specialists to reduce the workload of secondary- and tertiary-level healthcare workers. The government seeks to increase total health expenditure to 12% of the central government budget and 5.0% of GDP, up from the current 9.2% and 2.8%, respectively. Monthly health expenditures for individuals above the poverty line have almost tripled in less than 10 years, increasing from 6,675 MNT ($2.30) in 2007 to 15,251 MNT ($6.40) in 2016.
Mongolia allows 100% foreign ownership of businesses. However, U.S. companies may want to consider working with reputable local partners (agents or distributors) with experience and knowledge of local market, statutes, and regulations. For information on entering the Mongolian market see the current Mongolia Country Commercial Guide.
As the dominant healthcare provider, the government has the most extensive facility network and is the largest purchaser of drugs, expendable medical supplies, and medical equipment. However, an increasing number of private hospitals and clinics are opening, with more expected in the future. Specific government priorities include improving treatment of liver diseases, maternity and child care, and communicable diseases, as well as mitigating pollution-induced respiratory ailments.
Mongolia’s growing middle and upper-classes are more able and willing to pay for higher levels of care, manifesting itself in demands for better quality medical equipment, procedures, pharmaceuticals, and nutritional supplements.
Companies from China and Europe are the main competitors for U.S. medical device exporters. Consumable healthcare products from China are also very competitive in the market. In addition to U.S.-sourced prosthetic devices, Mongolian medical businesses also source prosthetic equipment from India and China.
Companies from India, China, the Czech Republic, Germany, Russia, South Korea, and Japan also market health supplements and pharmaceuticals in Mongolia.
The relatively high cost of treatment and, more importantly, the general lack of trust in Mongolian physicians and their diagnoses has driven Mongolians to seek treatment overseas. Estimates suggest that over 80,000 Mongolian patients spend $120-150 million on overseas medical treatment annually, with up to $66 million and $50 million going to China and South Korea, respectively.
Mongolia relies heavily on imported drugs, which account for 80% of the market. In 2016, the country imported almost $106 million in drugs, with more than 50% coming from Russia, Slovenia, Germany, Hungary, India, and China. U.S. pharmaceutical products accounted for approximately 0.2% of the market. However, interest in higher-quality U.S. drugs is growing as the Mongolian public become increasingly wary of counterfeit Russian and Chinese drugs. Estimates place the level of counterfeit drugs sold on the local market at up to 60%. For such nutritional supplements as vitamins, U.S. products account for nearly 43% of the Mongolian market.
Importers of drugs and medical devices must submit the following documents in paper or by CD to the Ministry of Health: http://www.mohs.mn/p/78:
1. Fast track “A” registration
2. Fast track “B” registration
3. Standard registration
4. Domestic drug registration
5. Imported traditional medicine registration
6. Domestic traditional medicines registration
7. Domestic diagnosing devices
8. Imported diagnosing devices
9. Medical raw materials registration
10. Imported bio-active substance registration
11. Domestic bio-active substance registration
Ministry of Health Order No 404, On the Requirements for Medical Equipment, and the Mongolian Law on Licensing, allow for import of medical equipment and devices through Mongolian entities holding special permits/licenses. In addition to the permit, the importer and exporter must have a formal agreement between themselves. The Ministry of Health will then issue an import license. Neither the regulation nor the law specifically requires importing entities be owned and/or operated by Mongolians; rather, the importing entity must be registered in Mongolia. Such a company can apply for a one-time import license from the MOH (http://licemed.mohs.mn/). MOH is required to issue a decision on the import license within 5 working days.
In addition to obtaining a permit from MOH, importers/exporters also have to work with two other government entities: The General Authority for State Inspection (GASI) and the Mongolian Customs General Administration (MCGA). GASI (http://inspection.gov.mn/) examines product quality and quantities while MCGA (http://www.ecustoms.mn/) looks into payment of appropriate taxes, proper permitting, proper labelling and packaging, and certificates of origin.
How Mongolia reimburses for medical procedures and devices remains opaque, but the reimbursement system for drugs is clearer.
Initiated in 1994, the drug reimbursement regime reimburses participants for “essential drugs” on an annually updated list approved by the Social Health Insurance Agency (SHIA). SHIA issues a list of the costs of essential drugs. This list sets the maximum price level for these drugs and stipulates the extent to which SHIA will cover drug costs. SHIA selects drugs for reimbursement based on mortality and morbidity rates for the last 2 years and drug consumption listed by pharmacological classification. To date, insured ambulatory patients have access to a total of 134 essential drugs, partly reimbursed by the state Health Insurance (HI), providing that a family doctor in either urban or rural settings proscribes them and a SHIA designated or contracted pharmacy dispenses them. For more information on drug reimbursement: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327554/.
Mongolia imposes no specific barriers for importing foreign medical products. However, close relationships between some domestic importers of medical products and the management of state-owned hospitals can act as a barrier to new market entrants. Corruption and conflicts of interest can affect the public tendering and procurement process. Mongolia’s domestic patent system is not developed enough to ensure protection of importers’ intellectual property rights. Regarding protection of intellectual property rights in Mongolia see the 2018 Mongolia Investment Climate Statement.
Find information regarding procurement and tender opportunities in Mongolia at http://www.medicaltenders.com/medical_tenders_mongolia.htm and at the Ministry of Health of Mongolia, http://www.mohs.mn/home.
Ulaanbaatar Partnership Expo – International Expo
September 6-9, 2018
Misheel Expo Center
POC: Mongolian National Chamber of Commerce & Industry
Tel: + 976 7010 9090
Expo Mongolia 2018 - International Mining & Multi Sector Trade Fair
October 9-11, 2018
Misheel Expo Center POC: J.V. Consult LLC
Tel: +976 7000-9471
U.S. Commercial Service Contact Information
Name: Michael D. Richmond
Position: Senior Commercial Specialist
Phone: +976 7007 6001
For general questions regarding issues related to exporting, please see: https://www.export.gov/Export-FAQs. For questions regarding exporting to Mongolia, please refer to the Mongolia Country Commercial Guide.
Pharmaceuticals: Mongolia’s pharmaceutical market generated $100 million in business in 2016 (domestically manufactured drugs accounting for 20%) and is expanding by 10% annually. Mongolian importers seek liver medicines, anti-aging drugs, cancer medications, and nutritional supplements. Mongolian pharmaceutical importers also seek technology and expertise to expand domestic capacity to manufacture pharmaceuticals.
Additional sub-sector best prospects include selling medical implants, providing IT support services, selling medical equipment, developing cold storage facilities, and facilitating knowledge and skills transfers.
Healthcare spending (including investment)
... as percent of GDP
… of which spent on inpatient services (including long-term care)
… of which spent on pharmaceuticals/consumables
…of which spent on investments
Hospitals, Procedures, Healthcare Professionals:
Number of hospitals
Number of hospital beds
...available beds per capita
7.7 beds/1,000 people
Number of surgical procedures:
…of which are surgical procedures on the nose, mouth, or pharynx
…of which are gastrointestinal surgical procedures
...of which surgeons
...of which internists
...of which pediatricians
13.6/1000 live births
Percent of population older than 65
5.1 deaths/1,000 people
…caused by cardiovascular disease
…caused by cancers
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