Monitoring adverse drug reactions is a vital issue to ensure drug safety and to protect the general public from medication-related harmful effects. In order to properly monitor drug safety, a regulatory system needs to be in place as well as an infrastructure that allows for analyzing national and international safety data. In Mongolia, adverse drug reaction (ADR) reporting activities have been implemented in the past decade. During this period, the basic structure and legal basis of an adverse drug reaction monitoring system was established. Because of the fragmented but growing healthcare system and the complexity of pharmaceutical issues in Mongolia, a sustainable process for the development of the adverse drug reaction reporting system is a key issue. The aim of this article is to disclose the Mongolian situation for the rest of the world and to share experiences on how an ADR reporting system can be developed towards a higher and more advanced level to contribute to both national and international drug safety issues. In this article, we review the features of the Mongolian health care and pharmaceutical systems, as well as the current development of the adverse drug reaction reporting system.

As cardiovascular diseases are the major global health problem, the management of cardiovascular medicines (CVMs) should not be out of attention. We aimed to identify CVMs needing strict management control, used in 2017 and 2018 to investigate if there was a possibility to make savings in the expenditure for CVMs if the proper management was done regarding Class A medicines at the Regional Diagnostic Treatment Center of Khovd aimag in 2018. Aggregate data methods, Always, Better and Control (ABC), Vital, Essential and Non-essential (VEN), and ABC-VEN matrix analyses were used to identify the categories of CVMs, included in the Essential Medicine List of Mongolia for the year 2017 and 2018. Class A medicines represented 23.81% and 30.43% of the total CVMs and consumed the largest proportion of the total budgets at 73% and 71% in 2017 and 2018, respectively. The Category I, which requires strict management control, contains the majority (an average of 59%) of total CVMs and amounting for an average of 78.67% of total expenditures in 2017 and 2018. We conclude that the Regional Diagnostic and Treatment Center could have saved a total of 6,646,500 MNT if the proper management regarding Class A medicines was done in 2018 based on the results of ABC, VEN, and ABC-VEN matrix analyses of 2017.

Objective: Our purpose was to use the Beers criteria to determine potentially inappropriate medications in people 65 years of age and older who were hospitalized in the Nephrology and Endocrinology Department of The Second General Hospital in Ulaanbaatar, Mongolia from October to December in 2017. Methods: A total of 75 patients' medical records were selected who were aged ≥ 65 and diagnosed with kidney diseases. The patient's age, sex, serum creatinine, the number of potentially inappropriate medications prescribed were determined. Descriptive statistics, frequency analysis, and t-tests were used for normally distributed variables. The Mann-Whitney U test was used for variables with a non-normal distribution. Results: Most patients for whom data were creatine clearance data were available (36/41, 87%) were prescribed at least one potentially inappropriate medication, and the number prescribed of potentially inappropriate medications was moderately correlated with length of hospital stay (r= .326, p < .05). The frequency of potentially inappropriate medications prescribed in patients with CrCL <60 ml/min was significantly higher than in patients with CrCL level 60 -90 ml/min (29/31 vs. 7/10, X 2 (1) = 50.45, p < .001). A total of 195 potentially inappropriate medications were prescribed to 75 elderly patients diagnosed with renal disease, and these included antibiotics, anticonvulsants, proton pump inhibitors, and calcium channel blockers. Conclusion: Potentially inappropriate medications were frequently prescribed to hospitalized geriatric patients with kidney disease. Health care professionals in Mongolia need to collaborate to optimize pharmacotherapy based on renal function to avoid the complications of potentially inappropriate medications for geriatric patients with kidney disease.