UAE Law and Practice Contributed by: Haykel Hajjaji, Julie Teperow, Robin Blaney and Winsome Cheung, Covington & Burling LLP
For UPP‑listed pharmaceuticals, reimbursement is generally limited to the permitted markup on the pub- lic price. Reimbursement is only allowed if the medi- cal product falls under government‑funded insurance programmes (including Thiqa, basic health insurance, and Abu Dhabi‑funded mandates). Medical products not included in the UPP but covered under approved government programmes – ie, those provided free of charge or subsidised – are reimbursed at the public drug price. Under DOH rules, medical devices are incorporated into bundled payments for inpatient and ambulatory services, particularly under the IR‑DRG methodology. 8.4 Cost-Benefit Analyses There is currently no federal Health Technology Assessment (HTA) framework in the UAE. As of 2025, Abu Dhabi is the only emirate with a formal HTA sys- tem in place, which focuses on new and innovative technologies. Notwithstanding the above, Cabinet Resolution No 87 of 2023, which established the Supreme National Committee for Unified Procurement (“Procurement Resolution”), addresses – at least in part – principles relevant to cost‑benefit considerations. One of the overarching principles guiding the federal Committee for Unified Procurement (“Committee”) is “achieving financial savings” within the unified pro- curement system. This principle is supported by the Committee’s author- ity to identify procurement opportunities, assess the medical products market, and monitor the negotia- tions between suppliers and manufacturers. The DOH issued the HTA Guidelines, which outline how economic evaluations are to be carried out under the HTA process. Prior to the recommendation of new or innovative health technologies, economic evaluations are con- ducted in order to determine if they should be recom- mended or not. This involves the following.
• A cost-effectiveness analysis, which considers costs and health outcomes against alternative health technologies. • Budget-impact analysis – assessing both short‑term and long‑term budgetary implications. • Therapeutic added-value – evaluating the clinical benefits of the new technology relative to existing options. A new or innovative product cannot be considered without an HTA submission addressing all three fac- tors above. HTA findings are also taken into account when deter- mining the pricing of pharmaceuticals, medical devic- es, and medical services. However, pricing decisions are not based solely on a cost‑benefit assessment; rather, all three evaluation factors are considered. For reimbursement purposes, Abu Dhabi government insurance programmes will reimburse a pharmaceuti- cal product or medical device after the manufacturer or distributor submits an HTA dossier containing the relevant clinical and economic evidence. These HTA dossier submissions are assessed according to the product’s clinical effectiveness, cost‑effectiveness, budget impact, and therapeutic added value. 8.5 Regulation of Prescriptions and Dispensing by Pharmacies Prescriptions and dispensations are regulated at the federal level under the Pharma Law, and at the emirate level by the DHA and DOH. In Dubai, according to the DHA’s Pharmacy Guide- lines, pharmacists may only dispense the medical product specifically prescribed. They are prohibited from directing customers toward any other medical products that are not included in the prescription. Within Dubai Healthcare City Freezone, additional regulations apply on top of federal and emirate-level rules. A pharmacist may not dispense a generic equiv- alent if the prescription includes a note prohibiting substitutions. A generic may also not be dispensed if its price is the same as or higher than the prescribed brand. If the prescription does not prohibit substitu- tions, the pharmacist may dispense a generic equiva-
377 CHAMBERS.COM
Powered by FlippingBook