A decade of liver transplantation in Mongolia: Economic insights and cost analysis

TL;DR

This study analyzes the costs of liver transplants in Mongolia over 10 years, revealing high expenses and significant unmet healthcare needs.

Contribution

The study provides the first detailed economic analysis of liver transplantation in Mongolia, a lower-middle-income country.

Findings

The average liver transplant cost in Mongolia is $39,589, with 79.6% being direct costs.

Costs vary by CTP score classification, with statistically significant differences observed.

The waiting list for liver transplants exceeds 300 people despite annual treatment capacity for 50 patients.

Abstract

Mongolia introduced liver transplantation 10 years ago, becoming the 46th country globally to successfully perform this procedure. However, the cost of liver transplantation treatment remains expensive in Mongolia, a lower-middle-income country. Thus, the need to calculate the cost of liver transplants, a highly-valued treatment, forms the basis for this study.

This study employed a retrospective research design with secondary data. The primary dataset comprised 143 cases of liver transplantation performed at the First Central Hospital of Mongolia between 2011 and 2021.

The average cost of a liver transplant in Mongolia is $39,589 ± 10,308, with 79.6% being direct costs and 20.4% indirect costs. Of the direct costs, 71% were attributed to drugs, medical equipment, and supplies, while 8.6% accounted for salaries. In terms of the Model of End-Stage Liver Disease (MELD) scores, treatment costs were $39,205 ± 10,786 for patients with MELD ≤ 14 points, $40,296 ± 1,517 for patients with MELD 15–20 points, $39,352 ± 8,718 for patients with MELD 21–27 points, and $39,812 ± 9,954 for patients with MELD ≤ 28 points, with no statistically significant difference (P = 0.953). However, when calculated according to the Child-Turcotte-Pugh (CTP) score classification, treatment cost for CTP-A patients was $35,970 ± 6,879, for CTP-B patients $41,951 ± 12,195, and for CTP-C patients $37,396 ± 6,701, which was statistically significant (Р=0.015).

The average cost of liver transplantation treatment in Mongolia was $39,589. Despite medical facilities’ capacity to treat up to 50 patients annually, the waiting list exceeds 300 individuals, highlighting significant unmet healthcare needs.

Figures