The UAE is currently undergoing a strategic shift to value-based healthcare (VBH) to support a more patient centric approach to care whilst ensuring financial sustainability. This transformation is driven by a high regional burden of non-communicable diseases (NCDs) and genetic disorders, alongside the escalating costs of specialty pharmaceuticals. Central to this transition is the institutionalization of Health Technology Assessment (HTA).

HTA in the UAE:[1]

The UAE aims to optimize health outcomes relative to cost by aligning reimbursement with real-world performance. HTA informs what should be covered through evidence-based approval. The UAE’s Health Technology Assessment (HTA) landscape has shifted from a fragmented, ad-hoc system to a structured, data-driven environment. 

The Emirates Health Service (EHS) has implemented a phased roll out of a more sophisticated HTA process:

• Phase 0 (Strategy & Foundation): Focus on stakeholder mapping, establishing a core HTA team, and aligning with international methodologies
• Phase 1 (Economic Analysis): Focus on Budget Impact Analysis (BIA) and Burden of Disease (BOD) studies to identify high-priority therapeutic areas
• Phase 2 (Value-Based Contracting): Implementation of Managed Entry Agreements (MEAs) and more complex health economic modeling
• Phase 3 (Full Adoption): Full integration into the procurement cycle with periodic performance metrics and post-market reassessment

Abu Dhabi HTA:[2]

In June 2025, the Department of Health – Abu Dhabi (DoH) established a formal process that sets out how new health technologies will be reviewed before they can be accepted and funded in Abu Dhabi.

The scope of the HTA guidelines in Abu Dhabi covers innovative drugs , medical devices, AI and IoT tools, and digital health platforms. Appraisals are specifically mandated for technologies launching in a first or new indication, targeting new patient populations, or being offered in new dosage forms. Furthermore, high-cost products defined as those with an annual budget impact exceeding AED 10 million or a cost-per-patient exceeding AED 100,000 per year are subject to intensified scrutiny.

HTA in Abu Dhabi now follows two parallel tracks: a clinical assessment and an economic assessment. 

1. Clinical Assessment: Led by the Health Life Sciences Sector, this evaluation examines mortality, morbidity, quality of life (QoL), and functional outcomes. The DoH requires high-quality evidence, ideally from randomized controlled trials (RCTs), but it also places significant weight on real-world evidence (RWE).
2. Economic Assessment: Conducted from the payer’s perspective, this assessment requires both a Cost-Effectiveness Analysis (CEA) and a Budget Impact Analysis (BIA). The primary metric utilized is the Incremental Cost-Effectiveness Ratio (ICER), which must be compared against a set threshold to determine if the technology offers value for money.
   1. Managed entry agreements (MEAs) for high-cost therapies with significant budget impacts must be integrated into the economic model. Submissions should include both a base case without the MEA and a specific scenario incorporating the agreement.

After evaluation, the DoH issues recommendations based on medical value. High recommendation status mandates reimbursement, while Moderate recommendation  leads to Managed Entry Agreements (MEAs) or temporary coverage with the expectation of additional data generation activities to be undertaken by the manufacturer. Low/Insufficient recommendation typically results in reimbursement rejection, though companies can appeal or resubmit with adjusted pricing.

Early Advice:

The DoH offers a structured HTA Early Advice mechanism for manufacturers to consult with its multidisciplinary team during early development or prior to EDE submission. This process facilitates:

• Determining if a full HTA review is mandatory at launch.
• Gaining clinical trial feedback on endpoints and comparators.
• Addressing evidence gaps to avoid potential rejection.
• Evaluating economic model feasibility and local data needs

Opportunities: 

For biotech and medtech  firms, HTA acts as a Value-Gate, requiring rigorous evidence for market access. The HTA ensures health system funding for breakthrough treatments by providing a structured path to systematic reimbursement. The framework supports value-based pricing by enabling companies to justify premium pricing through documented clinical efficacy. For high-cost innovations, HTA enables managed access and risk-sharing models, allowing earlier patient access and revenue generation while long-term data is gathered.

For Healthcare Professionals (HCPs) and specialists providing care for rare and ultra-rare diseases, this means that the choice of a breakthrough treatment is now supported by a multi-disciplinary validation of its therapeutic added value compared to the standard of care. This added value considers factors such as improved efficacy, reduced side effects, and better patient quality of life.

For payers the Health Technology Assessment (HTA) appraisal serves as the essential mechanism for rationalizing coverage and reimbursement decisions. The inclusion of Managed Entry Agreements (MEAs) within the HTA process provides a flexible approach to financing innovation, with a regard to safe-guarding against those where therapeutic value is unclear.  This enables controlled patient access while facilitating financial risk-sharing between manufacturers and payers.

Conclusion:

The institutionalization of Health Technology Assessment (HTA) represents a pivotal milestone in the UAE’s transition toward a sustainable, value-based healthcare ecosystem. It provides a transparent roadmap for biotech and medtech firms to demonstrate the real-world impact of their therapies, empowers healthcare professionals with evidence-backed treatment options, and offers payers a mechanism to mitigate the financial risks associated with high-cost specialty pharmaceuticals. 

References:

1. Health technology assessment infrastructure for emirates health services: a phased framework
2. Department of Health – Health Technology Assessment Guidelines