OBJECTIVES:  The research was aimed at understanding the complexities of pricing and reimbursement practices in UAE with analysis focussing on price mark-ups, affordability, stakeholder analysis and strategic recommendations for pharmaceutical companies to launch products in this market. METHODS:  Interviews were conducted with Payers and KOLs to understand patient flow, health care issues and drug pricing in UAE. In addition in-depth secondary analysis was conducted. RESULTS: UAE with a population of 4.2 million has seen more than 700% growth from 1975-2006, contributed mostly by expatriate work force. This has significantly impacted on the management of healthcare in recent years. Medicines priced in the UAE are generally high because of the lack of pharmaceuticals manufacturing base and subsequent reliance on imports. While individuals spend $52 in the gulf countries and $20 in other Arab countries on medicines, an individual in the UAE spends about $80 a year. There is a markup of up to 20% and 24% by the wholesalers and retail pharmacies respectively; which is relatively high in comparison to many other countries resulting in expensive drugs that become unaffordable. A lack of competition legislation and anti-competitive practices means that pharmacies in the UAE are required to buy medicines solely through few agents who hold exclusive rights to importing and distributing products. Also there are differences among the UAE regions; e.g.; HAAD is introducing additional controls through a differential co-payments and reference pricing when insufficient competition is observed. As part of market access policy development, the UAE MoH has started applying basic pharmaco-economic methodologies that considers the active ingredient’s strength, dosage, and therapeutic effect. CONCLUSIONS: The pricing and reimbursement policy in its current form is not-sustainable. New pricing models need to be considered in order to ensure a healthy population with good access to affordable medicines and health care in the UAE.