Epidemiology, health care coverage and cost challenges change the healthcare environment and, unavoidably, pharmaceutical care, in the Middle East and North Africa (MENA) region. The focus is increasingly on health care and, predominantly, pharmaceutical cost containment, rather than efficiency improvements and reward for value.

The MENA geographical region includes countries with diverse economic status and health care systems – often very fragmented – and the application of health economic methods for health policy decisions, such as Health Technology Assessment (HTA) prior to pricing and reimbursement of pharmaceuticals and innovative contracting, is much less advanced compared to other geographical areas. While all countries are looking to reform their health systems, there is still room for significant improvement in order to streamline often fragmented systems and improve access to care and population health outcomes.

This report outlines and critically analyses the current pharmaceutical pricing and reimbursement policies and regulation in the MENA region and pays special attention to external reference pricing (ERP), the most commonly used pricing policy in the region. The focus of the report is on 11 countries: Algeria, Egypt, Morocco, Lebanon, Jordan, Saudi Arabia and the rest of the Gulf Cooperation Council (GCC) countries: Kuwait, United Arab Emirates (UAE), Qatar, Bahrain and Oman.

Beyond mapping, analysing and critically appraising local pricing and reimbursement policies for pharmaceuticals and their interaction with each other, the report aims to recommend ways of improving current policies and practices and outlining a transition to a more robust value-based pricing system in the study countries. In doing so, the report also aims to motivate a positive dialogue around pricing, reimbursement and sustainability in the MENA region, as well as around the shared interest of patient access to medicines.

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