Driving the Future of Value-Based Healthcare in the Gulf Cooperation Council: A Roadmap for Achieving Sustainable Access to Specialty Pharmaceuticals

Anas Hamad^1,2*Ahmed Aljedai³Rita Ojeil⁴Abdulrazaq Al-Jazairi⁵Adel Al Assy⁶Yazed AlRuthia⁷Waiel Al Naeim⁸Hajer Almudaiheem⁹Mouza Al Saadi¹⁰Nada Alagil¹¹Lina Wahba¹²Abdulmohsin Marghalani¹³Amna Al Hashar¹⁴Abdullah Alshehry¹⁵Sana Alblooshi¹²Ibtisam Alharbi¹⁶Marleine Bejjani Moukarzel¹⁷Sara Albalushi¹⁸Ahmed El- Sheashaey¹⁹Mobamed Aseeri²⁰Farid Alenezy¹⁹Fathea Adheir²¹Abdulrahman Aloumi²²Rehab Al Noaimi²³Khalid A. Alnaqbi²⁴

• ¹Hamad Medical Corporation, Doha, Qatar
• ²National Center for Cancer Care & Research, Doha, Qatar
• ³Alfaisal University, Riyadh, Saudi Arabia
• ⁴Pharmaceutical Development Company, Dubai, United Arab Emirates
• ⁵King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
• ⁶M42, Abu Dhabi, United Arab Emirates
• ⁷King Saud University, Riyadh, Saudi Arabia
• ⁸Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
• ⁹Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
• ¹⁰Dubai Health Authority, Dubai, United Arab Emirates
• ¹¹Council of Health Insurance, Riyadh, Saudi Arabia
• ¹²Tawam Hospital, Al Ain, United Arab Emirates
• ¹³King Abdulaziz University Department of Pharmacy Practice, Jeddah, Saudi Arabia
• ¹⁴Sultan Qaboos University College of Science, Seeb, Oman
• ¹⁵Knowledge Building Company and Ray Training Centre Saudi Arabia, Riyadh, Saudi Arabia
• ¹⁶Government Confidential, Jeddah, Saudi Arabia
• ¹⁷Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
• ¹⁸National Ambulance, Abu Dhabi, United Arab Emirates
• ¹⁹Kuwait Cancer Control Center, Shuwaikh, Kuwait
• ²⁰Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
• ²¹Sidra Medicine, Ar-Rayyan, Qatar
• ²², Kuwait Pharmaceuticals & Herbal Medicines Registration and Control Administration, Kuwait, Kuwait
• ²³Salmaniya Medical Complex, Manama, Bahrain
• ²⁴Sh Tahnoon Bin Mohammed Medical City, Al Ain, United Arab Emirates

Gulf Cooperation Council (GCC) countries are undergoing a critical transformation in their healthcare systems. This empowers them to address the rising burden of complex diseases, including rare diseases, cancer, neurological disorders, and immunological illnesses, which involve a high cost of therapy. A strategic shift from volume-to value-based healthcare (VBH) emphasizes sustainability, enhanced accessibility, and improved health outcomes through innovation. GCC's healthcare is marked by universal coverage and a shifting landscape of public-private partnerships. Rising pharmaceutical costs, especially for specialty drugs, continue to challenge budget sustainability. VBH offers a strategy to align healthcare expenditure with patient outcomes. This framework is supported by global and regional models such as managed entry agreements (MEAs), multi-criteria decision analysis, and real-world evidence (RWE). These models provide guidance for reimbursement strategies and support decision-making regarding high-value treatments. The GCC nations are also progressing towards policy discussion, but face challenges related to infrastructure, regulation, and workforce capacity. The Department of Health (DOH) in Abu Dhabi, which is a governmental health authority in the United Arab Emirates, has officially established a dedicated HTA unit to evaluate and assess new health technologies for evidence-informed decision making. This review highlights specialty care priorities and proposes target strategies such as expanding genetic databases, implementing screening programs, and establishing risk-sharing agreements to improve affordability, particularly for rare diseases. A consensus-driven phased roadmap for GCC-wide VBH adoption is recommended. This includes a focus on MEAs and patient-reported outcome measures, mid-term harmonization of health technology assessments (HTA) and RWE development as well as long-term establishment of digital ecosystems and value-based pricing platforms. Equitable and collaborative policies will be essential to achieving sustainable and inclusive healthcare systems across the GCC.