BEYOND IMPORTED ASSUMPTIONS: A STRATEGIC ROADMAP FOR PATIENT-LEVEL CLINICAL COSTING IN GCC HEALTH SYSTEMS
Author(s)
Shoaib Dar, BSc, MSc1, Abdulrazak Aljazairy, PhD2, aljawharah fawaz alkoraishi, PhD3, Amal Yassine, Jr., PhD4, Elliot Gyimah, Sr., MBA1, Eshtyag Bajnaid, Sr., BSc, MSc5, Fatimah Alyami, PhD6, Anshu Singhania, Sr., BSc, MSc7, Manal Al-Ansari, Sr., BSc, MSc8, Kristian McCormack, Sr., PhD9, Mohamed Farghaly, MD10, Mahmoud M. Tolba, BSc, MSc11, Mohamed Tannira, BSc, MSc12, Mutaz Ahmed, BSc, MSc13, Nadia Al Mazrouei, PhD14, Osama Mohamed Ibrahim, PhD15, Pinar Egeli, BSc; MS7, Sahar Fahmy, PhD1, Sahar Hassan, BSc, MSc11, Samar Mansour, PhD12, Sara Mohibullah Al Balushi, III, BA16, Marthinus Stander, MBA, MD17, Tomaz Klusztzynski, Sr., PhD18, James Pearce, PhD1.
1Department of Health, Abu Dhabi, United Arab Emirates, 2Clinical Trials Transformation Initiative Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, 3King Saud University Medical City, Riyadh, Saudi Arabia, 4Moroccan Society for Health Products Economy & ISPOR Maghreb Chapter, Mohammedia, Morocco, 5Clinical Pharmacy Department, King Abdullah Medical City, Makkah, Saudi Arabia, 6Center for Health Technology Assessment (CHTA) - Center for National Health Insurance (CNHI), Riyadh, Saudi Arabia, 7IQVIA, Dubai, United Arab Emirates, 8Ministry of Health, Muscat, Oman, 9Health Holding Company, Riyadh, Saudi Arabia, 10Dubai Medical College, Dubai, United Arab Emirates, 11Health Evidence & HEOR Department, Stellar Consulting MEA, Dubai, United Arab Emirates, 12ISPOR UAE Chapter, Dubai, United Arab Emirates, 13M42 Health, Abu Dhabi, United Arab Emirates, 14Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates, 15Department of Clinical Pharmacy, Faculty of Pharmacy, New Giza University, Cairo, Egypt, 16Directorate General of Medical Supplies-M.O.H, JEDDAH, Saudi Arabia, 17Value in Research, Cap Town, South Africa, 18School of Business, Warsaw University of Technology, Warsaw, Poland.
1Department of Health, Abu Dhabi, United Arab Emirates, 2Clinical Trials Transformation Initiative Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, 3King Saud University Medical City, Riyadh, Saudi Arabia, 4Moroccan Society for Health Products Economy & ISPOR Maghreb Chapter, Mohammedia, Morocco, 5Clinical Pharmacy Department, King Abdullah Medical City, Makkah, Saudi Arabia, 6Center for Health Technology Assessment (CHTA) - Center for National Health Insurance (CNHI), Riyadh, Saudi Arabia, 7IQVIA, Dubai, United Arab Emirates, 8Ministry of Health, Muscat, Oman, 9Health Holding Company, Riyadh, Saudi Arabia, 10Dubai Medical College, Dubai, United Arab Emirates, 11Health Evidence & HEOR Department, Stellar Consulting MEA, Dubai, United Arab Emirates, 12ISPOR UAE Chapter, Dubai, United Arab Emirates, 13M42 Health, Abu Dhabi, United Arab Emirates, 14Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates, 15Department of Clinical Pharmacy, Faculty of Pharmacy, New Giza University, Cairo, Egypt, 16Directorate General of Medical Supplies-M.O.H, JEDDAH, Saudi Arabia, 17Value in Research, Cap Town, South Africa, 18School of Business, Warsaw University of Technology, Warsaw, Poland.
OBJECTIVES: To develop a strategic framework for implementing patient-level clinical costing in the GCC to strengthen local value dossiers, support value-based pricing, and enable innovation adoption.
METHODS: A qualitative expert-consensus study was conducted via a moderated panel of 19 multidisciplinary stakeholders representing regulatory, provider, financial, and international HTA expertise. Discussions were structured around six pillars: reimbursement design, value dossier development, operational implementation, clinical engagement, infrastructure, and international benchmarking. Insights were synthesized through thematic coding to identify barriers and develop a phased implementation roadmap.
RESULTS: Consensus identified patient-level micro-costing as the primary driver for pricing complex therapies and bundled care. Key findings included: Methodological Shift: Transitioning from cash to accrual-based accounting and adopting Time-Driven Activity-Based Costing (TDABC) are essential for capturing true episode-level data. HTA Credibility: Replacing imported assumptions with locally generated Real-World Evidence (RWE) and episode-level record data, significantly strengthens the clinical plausibility of value dossiers. Clinical Optimization: Framing costing as an "optimization instrument" rather than a cost-cutting tool is a critical strategy to secure clinician buy-in and improve workflow data capture. Maturity Gap: Regional VBHC failures are consistently linked to weak multi-stakeholder alignment and poor care integration.
CONCLUSIONS: Patient-level clinical costing is a strategic prerequisite for fair reimbursement and sustainable innovation uptake. This roadmap allows GCC policymakers to embed costing early, moving toward locally relevant VBHC architectures that prioritize outcomes relative to precise resource consumption.
METHODS: A qualitative expert-consensus study was conducted via a moderated panel of 19 multidisciplinary stakeholders representing regulatory, provider, financial, and international HTA expertise. Discussions were structured around six pillars: reimbursement design, value dossier development, operational implementation, clinical engagement, infrastructure, and international benchmarking. Insights were synthesized through thematic coding to identify barriers and develop a phased implementation roadmap.
RESULTS: Consensus identified patient-level micro-costing as the primary driver for pricing complex therapies and bundled care. Key findings included: Methodological Shift: Transitioning from cash to accrual-based accounting and adopting Time-Driven Activity-Based Costing (TDABC) are essential for capturing true episode-level data. HTA Credibility: Replacing imported assumptions with locally generated Real-World Evidence (RWE) and episode-level record data, significantly strengthens the clinical plausibility of value dossiers. Clinical Optimization: Framing costing as an "optimization instrument" rather than a cost-cutting tool is a critical strategy to secure clinician buy-in and improve workflow data capture. Maturity Gap: Regional VBHC failures are consistently linked to weak multi-stakeholder alignment and poor care integration.
CONCLUSIONS: Patient-level clinical costing is a strategic prerequisite for fair reimbursement and sustainable innovation uptake. This roadmap allows GCC policymakers to embed costing early, moving toward locally relevant VBHC architectures that prioritize outcomes relative to precise resource consumption.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA73
Topic
Health Policy & Regulatory, Health Technology Assessment, Patient-Centered Research
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas