Overview
In the Emirate of Abu Dhabi (UAE), we supported the Department of Health (DoH) in establishing a structured programme to institutionalise Health Technology Assessment (HTA) for reimbursement decisions and broader benefit package design. Guided by the Evidence-Informed Deliberative Processes (EDP) framework, we worked with DoH to develop a practical roadmap for stepwise HTA implementation.
Rather than launching a full HTA agency immediately, the reform focused on stakeholder alignment, clear procedures and governance design. Through collaborative design and consultation, the resulting roadmap provides a multi-year plan to strengthen transparency, explicit decision criteria, stakeholder involvement, communication and local HTA capacity—aimed at improving value for money and the sustainability of health financing.
Context & Objectives
Abu Dhabi has compulsory health insurance with multiple schemes and benefit schedules across population groups. At the same time, healthcare spending pressures have increased due to demographic and epidemiological change and the rapid introduction of innovative (and often costly) technologies. Stakeholders recognised that HTA principles were present but not yet sufficiently embedded in a consistent, timely and transparent decision-making process.
DoH identified key challenges: limited internal capacity for economic and HTA analysis; dependence on external expertise; and unclear coordination and mandates between units responsible for market approval versus pricing and reimbursement. These issues contributed to delays and an accumulating backlog of technologies awaiting assessment.
The main objectives were to:
- Build and leverage local HTA expertise over time
- Develop a roadmap for institutionalising HTA that fits Abu Dhabi’s governance context
- Strengthen transparency and stakeholder involvement in reimbursement decisions
- Define and operationalise decision criteria
- Clarify mandates, procedures and organisational roles
Approach & Methods Used
- Situation analysis using desk research plus semi-structured (group) interviews
- Broad stakeholder engagement (45 stakeholders), organised across stakeholder categories
- Two workshops to discuss findings and shape roadmap building blocks
- Separate engagement with industry representatives via an online group interview
- Use of the EDP framework to structure roadmap components (governance, criteria, process steps, communication, appeal, monitoring)
- Development of a 5-year implementation roadmap, refined through meetings with senior DoH staff
- Formal approval of the roadmap for implementation
Outcomes
The process produced a DoH-approved, multi-year roadmap to establish a comprehensive HTA framework in Abu Dhabi. Key elements include setting up an HTA structure and committees embedded in the existing health sector set-up, defining scope and decision criteria, strengthening communication and transparency, and building sustainable HTA capacity.
Key learnings:
- Transparency and communication need explicit design, not ad hoc practice
- Broad stakeholder consultation built urgency, ownership and legitimacy for reform
- Clear mandates and coordination across regulatory and reimbursement functions are essential to avoid delays and backlog of HTA
- A phased roadmap is more feasible than immediate full-scale HTA institutionalisation
Collaborating Partners
Our work in Abu Dhabi has been done in collaboration with Abu Dhabi Department of Health, United Arab Emirates.