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Market access in the Middle East

05 June 2015 Cecilia Chui

Tracking shifts in MENA healthcare systems
Over the last decade, the MENA market access landscape has undergone significant transition that has garnered attention from investors and top-performing pharma companies alike. This has involved ambitious government healthcare reforms as both population and prevalence of chronic diseases continue to grow in the region. The governments are making strides towards universal insurance coverage, with Saudi Arabia rolling out employer-subsidised insurance for private sector workers, and the UAE introducing mandatory health insurance progressively.

Of course, market access in MENA is a function of the pricing and reimbursement landscape unique to each country, intertwined with cultural elements and the general nature of the operating environment. As we look at the various pricing methodologies in place in MENA, restrictive pricing and government cost-containment measures remain major concerns, especially as international reference pricing (IRP) becomes increasingly influential in these markets. Knowing the intricacies of the IRP process within and across markets will inform an optimal launch sequence, so that the outward impact of prices or price changes in reference countries is monitored and calculated.

However, this does not mean that market access should be predicated entirely on a price-based approach. Traditionally, market access involves engaging with a diverse set of stakeholders, and MENA is no exception. We found that in some markets in the region, targeting stakeholders beyond the traditional key opinion leaders, including payers, tendering bodies and advocacy groups, can have an increasingly important role in product uptake. Payers are increasingly sensitive to the potential risks of providing coverage for a new drug, balancing between the actual benefit of the product and keeping the healthcare budget under control. Hence some countries are beginning to consider economic evaluation during their recommendation and decision-making process, which is in turn creating new hurdles in obtaining reimbursement. This shifting environment suggests that market access in MENA will evolve to a more value-based approach with time, and means that companies will have to develop and articulate the appropriate value proposition while also positioning price optimally.

Keeping pace with the opportunities
Multinational companies will succeed by getting the basics right. They will sharpen their core functions to ensure effective management of relationships with all levels of government and key accounts in both the public and private sectors. They will make use of their global expertise to bring their local capabilities to global standards. They will understand the evolution and drivers of the market to build a comprehensive approach. They will launch programmes and partnerships most closely aligned with the areas of national importance from a policy standpoint.

For example, owing to the high rate of diabetes in the country, the Saudi government has approved a ten-year plan for diabetes control and a national diabetes programme; this creates opportunities for pharmaceutical companies to partner with the government to offer training to physicians and to aid screening and diagnosis.

In addition to these broad strategies, we have identified in a new study examples of innovative solutions, such as a growing interest in differential pricing, where pharma companies offer different price points in the public and private sectors. Such case studies mirror nicely what we analysed a previous study on intra-country tiered pricing strategies in emerging markets.

There is, of course, no single, one-size-fit-all solution, but while global strategies are being devised, MENA increasingly merits its own place in the thought process. Perhaps the key for multinationals to succeed in the region is to leverage their global expertise while also possessing sufficient capability to adapt the model locally.

Last week we delivered our new study, "Market Access in the Middle East: How Pricing Reform Impacts Pharmaceutical Uptake Strategies," for which our team of analysts have carried out in-depth interviews with more than 40 stakeholders, including key payers and industry experts in the region. The report considers the current and evolving market access environment in a number of key MENA markets, including Egypt, Saudi Arabia, Turkey and the UAE.

While the commercial opportunity in MENA is attractive, realising this potential requires an understanding of the shifts in each market's healthcare system, and how to keep pace with the evolving landscape.

If you are interested in P&R issues in MENA, learn more about our new study and download a sample chapter, or read about our POLI service which can facilitate pricing analysis in the region. We would be delighted to talk to you about our findings and see how they can help to inform your strategies.

Cecilia Chui is a life sciences senior analyst for IHS
Posted on 5 June 2015



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