OBJECTIVES: Examine the latest reforms in External Reference Pricing (ERP), also known as International Reference Pricing (IRP), in the Gulf Cooperation Council (GCC) countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates (UAE).

METHODS: The latest ERP reforms in GCC countries were identified using GlobalData’s IRP 360 country profiles, IRP Matrix and headline analysis coverage of IRP reforms for the period from 1 January 2023 until 31 May 2024. ERP reforms approved over this period were assessed for alignment with the best practice guidelines for the use of ERP from the peer-reviewed 2019 Holtorf et al paper published in Value in Health Regional Issues.

RESULTS: Over the review period, Bahrain reformed the basket of countries it is referencing prices from under ERP. This reform, coming into effect on 17 September 2023, entails the removal of 12 of the 31 countries previously included in the reference basket. In Q4 2023, a new ERP basket was approved by the Gulf Health Council (GHC) for reporting of prices on the GCC countries’ Unified Pricing Form. The basket is not binding for GCC member states, yet in the ERP reform announced by Oman in January 2024 – and due to come into effect on 1 July 2024 – Oman announced it will cut the number of countries it is referencing from 30 countries plus the Country of Origin (COO) to the same 18 markets in the GCC form plus COO. After these reforms, the number of countries referenced under ERP are: 20 for Bahrain, 31 for Kuwait, 19 for Oman, 6 for Qatar and 17 for Saudi Arabia, and 19 for UAE. In contrast, the best practice guidelines recommend referencing 5-7 countries.

CONCLUSIONS: GCC countries, except Qatar, are referencing more countries than recommended, but the latest reforms improve alignment with best practice guidelines.