HARDER, BETTER, FASTER, STRONGER
But how quickly can a country truly transform its healthcare system, while making it sustainable for the future? The mindset
of Emiratis is that anything that is feasible and beneficial for the country should and will be done, regardless of the cost.
This is why health authorities have been moving at record speed to build new infrastructure and shape regulatory frameworks
worthy of a first-class healthcare system.
Walid Kattouha, head of Middle East Cluster for Novartis
Al Amiri from the MOH augurs that "the UAE is different from all other Arab countries. Certainly we are moving to improve
harmonization with GCC countries and other Arab countries, but the UAE has a different situation. Our business opportunities
are unique, the system of governmental procedure and regulations implemented here in the Emirates are completely different.
We do everything as a fast-track process, we support foreign investment and we consider them as strategic partners. The UAE
does not have difficulties with regulations because we are used to high transparency in our work and are moving to digitalize
our services so that they are available online."
Moritz Hartmann, general manager of Middle East for Roche Diagnostics
While the transparency of the country's government is generally lauded as exceptional in the world, particularly for the Middle
East region, some inefficiencies regarding health authorities do exist. Most notably is the tripartite split of regulatory
agencies, consisting of the MOH, Health Authority Abu Dhabi (HAAD) and Dubai Health Authority (DHA). Similar to the American
system of governance, where states are responsible for the laws specific to their geographies, the UAE is composed of seven
Emirates, each with its own government.
Giles Platford, area head of Middle East, Africa & Turkey for Takeda
Abu Dhabi is the political seat of the country as well as the oil basin, whereas Dubai has transformed itself into a financial
powerhouse by leveraging a service-intensive economy. As both these Emirates have progressed light years ahead of their five
other counterparts, they each decided to establish independent health authorities to regulate healthcare services. The MOH
is responsible for country-wide regulations, including product registration, import/export processes and pricing, as well
as overseeing healthcare provision in the less fortunate Emirates. In parallel, HAAD and the DHA each establish independent
regulations for reimbursement and the distribution of products in their respective Emirates. Basic economic theory would alert
to redundancies in such a system, where resources are wasted due to overlap and fragmentation.
Making a Stand for Rare Diseases
Despite this unusual set up, the common goal of bringing innovation as speedily as possible does seem to unite all three parties.
Executives in other parts of the world believe that innovation comes late to the Middle East, but nothing could be further
from the truth. Whereas in the past the region was slow to bring innovation, doctors today are very eager to use new products
and to have access to them. Now with the internet and all the available media, practitioners learn about the latest treatments
and immediately start searching for ways to use these new products for their patients.
Mohammad Zafrullah, vice president and general manager of GCC and Levant for GSK
Having arrived in Dubai only a few months ago to head Takeda's Middle East operations, Giles Platford provides his first impressions
of the GCC markets. "The UAE and KSA are markets where you have very professional healthcare institutions. Your private hospitals
are like five-star hotels, you've got public hospitals that are like private hospitals in other countries. Definitely the
standard of care here is good. The willingness to receive innovation is very high. An efficient approval process is reflecting
that. Typically, companies will foresee that the UAE will be the first market to launch in the region. I think the perception
of the UAE is very positive in the least."
Tailoring Diabetes to the Middle East
Almost unanimously, the UAE is considered the fastest adopter of innovation in the Middle East, allowing for the registration
of products immediately after they have been approved by the US FDA or the European Medicines Agency (EMA). This process can
take as little as 3-4 months, which has led some companies to designate the UAE as a priority launch country ahead of any
other emerging market.
Bassem Abdallah, country division head for Gulf States at Bayer Healthcare
AstraZeneca's president for the Gulf, Samer Al Hallaq, recounts that "generally the challenges in the Gulf region are related
to the fast pace of the market, which demands the introduction of new products into these markets. I would say these are positive
challenges and we are lucky to be considered early launch markets within the Middle East, because the healthcare system here
allows for speedy approvals and registration. We can bring innovation very quickly to this part of the world because of this
support to bring breakthrough and innovative medications."
Estimated Number of People Living with Diabetes in the MENA region (94% increase between 2010 and 2030)
"The real challenge then becomes ensuring access to the medication for all patients in the market and in all parts of the
country. Given that we have to deal with both private and public sectors, and each one has a different timeframe and approval
process, bridging those two is our priority. The advantage is that the private sector generally has a quick uptake of innovative
products, and governments support the fast entry of those products into the market to benefit those patients who can afford
them." This is particularly true for specialty and rare disease pharmaceuticals whose patient populations are tiny in a country
as small as the UAE.
Tara Banasi, regional manager of MENA for Aspen Pharmaceuticals
Until June 2013, the pricing of pharmaceutical products was entirely unregulated and companies were allowed to set prices
according to the general laws of market demand. On average, the UAE had some of the highest prices in the region for innovative
products given that healthcare is free for all Emiratis, and the majority of expatriates (about 90% of the population) are
insured by their employers. Furthermore, 80% of all pharmaceutical products are imported from the US and Europe, which inherently
makes them more expensive than locally manufactured drugs. European products in particular experienced drastic markups given
that they were purchased in Euros, while the local currency is pegged to the dollar, which exposed those products to currency
Jan Van der Goten, managing director of the GCC for Janssen
In a move to stabilize such oscillations, this past June the government implemented a round of price cuts that affected over
6600 pharmaceutical products out of a total 7500 registered. Beyond simple price slashing and price capping, the new regulation
mandates that all pharmaceutical products be priced according to their dollar value. As such, many products experienced price
decreases between 1-40%, while some products actually saw small increases. Nevertheless, the move has generally been welcomed
by the industry as it allows for improved forecasting now that prices will remain constant. Furthermore, as the GCC countries
move towards greater harmonization of regulation and pricing, these lower prices are better referenced with those of neighboring
"Some markets like UAE and Kuwait are willing to pay premium prices for innovation, but then when those products enter lower-income
neighboring countries, there needs to be an alignment in terms of prices. Typically this means that initially we have to set
lower prices in the higher-priced markets, so that they are comparable to prices in other countries", elaborates AstraZeneca's
Bayer Healthcare's Abdallah explains that "at Bayer we have established a policy of referencing prices across the entire region.
Eventually there might be some variations in the final price to consumers, but this is due to markups imposed by agents and
distributors, which of course vary from country to country. Currently there are efforts to unify prices across all the GCC
countries, including Saudi Arabia, with the aim of protecting the final consumer."