Organized by the ISPOR Arabic Network, a forum focusing on the Innovative Funding and Financing Models for Non-Communicable Diseases (NCDs) in LMICs in MENA Region was held on November 13th, 2023, during ISPOR Europe 2023. This event convened experts from MENA countries to discuss Innovative Funding and Financing Models for Non-Communicable Diseases (NCDs) in LMICs during ISPOR Europe 2023. The forum covered topics such as the disproportionate burden of NCDs in LMICs, challenges in healthcare access, and the crucial need for funding. Morocco's healthcare challenges, Lebanon's strategies during an economic crisis, and Egypt's fragmented healthcare funding were also explored. The presentations collectively emphasized the urgency of innovative funding models to address NCDs in diverse LMIC contexts. This brief summarizes reflections from these experts.
Innovative Funding and Financing Strategies for LMICs: A Roadmap to Universal Health Coverage in Non-Communicable Diseases
Presented by: Rita Karam, PharmD, PhD, Chair of ISPOR Arabic Network, Director of Quality Assurance of Pharmaceutical Products Program of Ministry of Public Health, and Professor of Faculty of Sciences and Medical Sciences, Lebanese University, Beirut, Lebanon
During the forum on Innovative Funding and Financing Models for Non-Communicable Diseases (NCDs) in Low- and Middle-Income Countries (LMICs) in the MENA Region, Dr Karam highlighted the disproportionate burden of NCDs in LMICs, accounting for 77% of related deaths globally, with a higher prevalence of cardiovascular disease, cancer, and chronic respiratory diseases. She emphasized the stark disparity in access to healthcare between developed and developing countries, pointing out that economically developed nations spend more due to financial capacity, unlike in Low- and Middle-Income Countries (LMICs) where there is suboptimal investment and access to healthcare. She stressed the paramount importance of adequate funding and financing for healthcare, crucial for achieving Universal Health Coverage (UHC). The presentation explored the challenges faced by LMICs in collecting funds and introduced innovative funding models, such as Development Impact Bonds and new tax-based ideas, to address the unique needs of each country and fill the funding gap for NCDs. Emphasizing the importance of prevention, early intervention, and improved patient outcomes, she underscored the critical need for these innovative funding solutions in tackling the growing burden of Non-Communicable Diseases (NCDs).
Non-Communicable Diseases: Financing challenges in the context of health innovation advancement: Case of Morocco
Presented by: Amal Yassine, MD, PHD, Moroccan Society for Health Products Economics (SMEPS) & Member of ISPOR Maghreb Chapter, Morocco
Healthcare expenses are growing at a much faster rate than financial resources. In Morocco, the generalisation of compulsory health insurance to the entire population is confronting the national health system with a continuous increase in health expenditure and the challenge of strengthening access to quality care and medical services under economic constraints. In this context, a reform of the national health system has been implemented, with the creation of new strategic structures and a change in the mode of governance.
Non-communicable diseases (NCDs) are a public health problem in Morocco. The epidemiological and demographic transition follows the international trend linked to the growth of the ageing population and lifestyle. The elderly population, aged over 60 years, constitutes 12.2% of the demographic, with a life expectancy of 76.7 years. According to the WHO, NCD mortality is the leading cause of death in the country. While the health system operates with financial autonomy, households bear 46% of the health expenditure burden. The system's current objective is to optimize available resources to ensure long-term viability, based on the strengthening of regulatory tools. Other sources of funding are also being sought, with a view to integrating therapeutic innovation by introducing health technology assessments (HTAs).
Lebanon's Response to Economic Crisis: Navigating Healthcare Challenges through Short-Term Subsidies and Long-Term Universal Health Coverage Initiatives
Presented by: Wadih Mina, Pharm D, MSc Pharmaceutical Marketing, MSc Health Economics, MSc Global Health Policy, ISPOR Lebanon Chapter- Chair elect, Roche Lebanon SARL-Pharmaceuticals Division
Lebanon is currently facing an unparalleled economic crisis that has significantly impacted all sectors, including healthcare. The country's currency has experienced a staggering depreciation of over 90%, severely limiting the ability to afford healthcare costs, particularly for imported consumables priced in foreign currency. In response to this funding shortfall, the presentation highlighted Lebanon's efforts to address the crisis through a variety of measures. These measures were classified into short-term strategies, such as the widespread subsidy of imported medicines, and longer-term initiatives, exemplified by the parliamentary endeavor to establish a universal health coverage law. The presentation concluded by summarizing the key insights gained from Lebanon's experience and extended an invitation for further research to document these lessons. This collaborative effort aims to provide valuable insights for other nations facing similar challenges in the future.
Non communicable diseases in Egypt and opportunities for innovative health financing
Presented by: Mahmoud Elmahdawy, PharmD, President, ISPOR Egypt Chapter
Healthcare funding is Egypt is fragmented with multiple sources of funding, currently the system is undergoing some changes and there are plans being implemented for UHC. Based on last data sets from National Health accounts the largest healthcare expenditures (approx. 55%) is attributed to Non communicable diseases which presents a big burden, in addition a high percentage of mortality in Egypt is linked to Non communicable diseases. This reinforces the burden of Non-Communicable Diseases (NCDs) and underscores the need for a heightened focus on prevention, awareness, and public health campaigns to alleviate this burden. Additionally, further utilization of Health Technology Assessment (HTA) principles is essential to optimize healthcare spending and encourage systematic evidence-based decisions for healthcare priority setting. Currently, Outcomes Based agreements are being explored.