Presentation (CTI)

OBJECTIVES: The Middle East and North Africa (MENA) region remains underrepresented in global health economic literature. This targeted literature review (TLR) assesses the volume, methodological quality, disease focus, and policy relevance of full economic evaluations in MENA (2015-2025), identifying key trends and evidence gaps.
METHODS: A systematic PubMed search was conducted to identify cost-effectiveness analyses published between January 2015 and June 2025 in MENA countries. Extracted data included country, disease area, population, model type and structure, perspective, time horizon, endpoints (e.g., QALYs, ICERs, DALYs), utility values, willingness-to-pay (WTP) thresholds, discounting, and sensitivity analyses.
RESULTS: Of 270 records screened, 68 met eligibility criteria. Publication volume rose sharply from 2022-2025 (n=41), reflecting increased regional engagement. Most studies originated from Saudi Arabia (n=20), Egypt (n=11), and Qatar (n=10). Commonly evaluated conditions included hepatitis C, breast cancer, multiple sclerosis, and cardiovascular diseases. Markov models predominated (60%), with decision trees and hybrid models also used. Most evaluations adopted a healthcare system perspective, applied a 3% discount rate, and used QALYs and ICERs as key endpoints. Sensitivity analyses were routinely conducted. However, most studies relied on international utility values (e.g., UK EQ-5D), limiting local applicability. WTP thresholds were inconsistently applied and often based on GDP multiples, highlighting the need for established WTP thresholds.
CONCLUSIONS: While economic evaluations in MENA are increasing in both volume and methodological rigor, they remain limited in geographic coverage and contextual relevance. Greater use of locally derived utility values and standardized, transparent WTP thresholds are essential to strengthen the credibility and policy impact of economic evidence in the region.