Purchasing health services under the Egypt's new Universal Health Insurance law: What are the implications for universal health coverage?

Khalifa, Ahmed Yehia; Jabbour, Jean; Mataria, Awad; Bakr, Magdy; Farid, Mai M.; Mathauer, Inke

doi:10.1002/hpm.3354

Cited by 10 publications

(10 citation statements)

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“…7 Demand side initiatives such as social franchising, voucher schemes are less commonly seen and are often implemented by non-governmental organisations (NGO) with funding from development partners. 7 Purchasing from private providers through stand-alone CO and also CO-I interventions have been underway in EMR countries of Egypt, 8 Iran, 9 Pakistan, 10 11 Jordan. 12 CO of private providers under insurance schemes is underway in Lebanon, 13 Tunisia, 14 Sudan 15 and Morocco, 16 whereas CO as the primary intervention was seen mainly in Afghanistan.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Purchasing from private providers through stand-alone CO and also CO-I interventions have been underway in EMR countries of Egypt,8 Iran,9 Pakistan,10 11 Jordan 12. CO of private providers under insurance schemes is underway in Lebanon,13 Tunisia,14 Sudan15 and Morocco,16 whereas CO as the primary intervention was seen mainly in Afghanistan 17…”

Section: Introductionmentioning

confidence: 99%

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Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation

et al. 2023

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ObjectiveThis paper provides a systematic review of evidence of government purchase of health services from private providers through stand-alone contracting-out (CO) initiatives and CO insurance schemes (CO-I) on health service utilisation in Eastern Mediterranean Region (EMR) to inform universal health coverage 2030 strategies.DesignSystematic review.Data sourcesElectronic search of published and grey literature on Cochrane Central Register of Controlled Trials, PubMed, CINHAL, Google Scholar and web, including websites of ministries of health from January 2010 to November 2021.Eligibility criteriaRandomised controlled trials, quasi-experimental studies, time series, before–after and endline with comparison group reporting quantitative utilisation of data across 16 low-income and middle-income states of EMR. Search was limited to publications in English or English translation.Data extraction and synthesisWe planned for meta-analysis, but due to limited data and heterogeneous outcomes, descriptive analysis was performed.ResultsSeveral initiatives were identified but only 128 studies were eligible for full-text screening and 17 met the inclusion criteria. These included CO (n=9), CO-I (n=3) and a combination of both (n=5) across seven countries. Eight studies assessed interventions at national level and nine at subnational level. Seven studies reported on purchasing arrangements with non-governmental organisations, 10 on private hospitals and clinics. Impact on outpatient curative care utilisation was seen in both CO and CO-I, positive evidence of improved maternity care service volumes was seen mainly from CO interventions and less reported from CO-I, whereas data on child health service volume was only available for CO and indicated negative impact on service volumes. The studies also suggest pro-poor effect for CO initiatives, whereas there was scarce data for CO-I.ConclusionPurchasing involving stand-alone CO and CO-I interventions in EMR positively impact general curative care utilisation, but lacks conclusive evidence for other services. Policy attention is needed for embedded evaluations within programmes, standardised outcome metrics and disaggregated utilisation data.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation

et al. 2023

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“…Its implementation, since July 2019, has seen the government relying on the private sector to lead the investments, with its own role greatly curtailed. 251 This creates space for the private sector to consider profit maximization rather than sustainable solutions for Egyptian citizens.…”

Section: Social Spending: Education and Healthmentioning

confidence: 99%

Investing Special Drawing Rights: Towards a fair economic recovery in the Middle East and North Africa

Aráuz¹,

Kiwan²,

Aasar³

et al. 2023

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“…In Egypt, the health system has been challenged by underinvestment and inefficiencies [ 10 ]. In 2019, the current health expenditure (CHE) was 4.74% of the Gross Domestic Product (GDP), which is less than the average of low and middle-income countries, 5.32% [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Maximizing the benefits of using biosimilars in Egypt

Fasseeh,

Elezbawy,

El-Fass

et al. 2023

J of Pharm Policy and Pract

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Background Biosimilars constitute a pathway for sustainable financing of healthcare systems in the era of expensive biologics. However, such a pathway is not free of challenges. Since the biosimilars market is expanding in Egypt, there is an urgent need for a policy framework to optimize their use and diffusion in the market. We aim to characterize a national framework based on the experiences of other countries and consultation with local experts. Methods A narrative literature review was conducted to identify biosimilars’ policy elements worldwide. A workshop was organized with experts to discuss the narrative review findings and create consensus on recommendations. Results The narrative literature review highlighted the need for biosimilar policy actions in four areas: market authorization, pricing, reimbursement, and uptake. Eighteen experts representing the Egyptian healthcare authorities attended the workshop. The most significant conclusions from the workshop included setting the price of the biosimilar at 30–40% less than its originator’s price and establishing financing protocols, in which the more expensive biologics with significant price premiums should be excluded from the formulary. Conclusions A summarized national framework policy recommendation for biosimilars was created by local experts from the main public healthcare entities in Egypt. These recommendations coincide with the international policies adopted across different countries that aim to improve patient access while sustaining health expenditure.

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Purchasing health services under the Egypt's new Universal Health Insurance law: What are the implications for universal health coverage?

Cited by 10 publications

References 4 publications

Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation

Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation

Investing Special Drawing Rights: Towards a fair economic recovery in the Middle East and North Africa

Maximizing the benefits of using biosimilars in Egypt

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