OBJECTIVES: There is a need as well as a demand for understanding the influences that are changing the landscape in terms of pharma management in the Middle Eastern region. This research is focussed on the UAE, one of the pioneers of a formal pharmaceutical assessment, to understand drivers of reform and implications. METHODS: Initial desk research was conducted to understand trends in reimbursement decisions and pricing of drugs. This was followed by in-depth interviews with 4 stakeholders in the Emirati system to understand historical influences, current trends, drivers for decision making and future changes expected. These data were analysed qualitatively to produce results. RESULTS: All respondents (n=4) thought of the UAE as one of the regional pioneers of adopting Western-style pharmaceuticals management systems. The imminent introduction of US-style PBMs is likely to be a major step in this direction. In addition, the government are working on the development of a centralised patient record that will include GCC/ME countries. This will help providers access patient history easily, prescribe more efficiently, avoid medication errors amongst other things. The increasing cost of drugs associated with the universal health insurance system (doubled national fund for the purchase of medicines this year) along with the high use of imported drugs was thought to be the most important driver for reform by majority of the respondents (n=3). All respondents were aware of the regional influence of the UAE reforms. CONCLUSIONS: P&R of pharmaceuticals is expected to move from a chaotic system to a more transparent, regulated one that requires submission of PE evaluations and clinical evidence. The MOH has already started developing a patient registry to assess validity claims from manufacturers. In a country where most of the drugs are imported due to lack of local manufacturing capabilities, it will become an increasingly important market for international manufacturers.