Submitted: 18 December 2014; Revised: 28 January 2015; Accepted: 1 February 2015; Published online first: 13 February 2015

Qatar is the world’s richest country per capita. The country established its National Health Strategy 2011–2016 in line with the Qatar National Vision 2030, which aims to advance Qatar’s Healthcare Vision of creating a world-class, patient-centred healthcare system [1, 2]. There has been a huge increase in public spending on health care in Qatar, giving it the highest per capita health expenditure in the Middle East. The National Health Insurance Scheme is a strong platform to ensure a healthy population with access to affordable health care.

Public sector drug procurement is carried out through closed international tenders, Gulf Cooperation Council (GCC) bulk procurement and direct purchasing. The Qatari pharmaceutical market reached a value of Qatari Rial 1.43 billion (US$392.6 million) in 2010. Spending on medicines and pharmaceuticals in 2009 and 2010, as a percentage of total public sector spending, was US$138 million (9%) and US$143 million (8%), respectively [3]. Medicines dispensed at the Hamad Medical Corporation (HMC) health institutions are priced differently for Qataris and non-Qataris. The development of the pharmaceutical market is shaped by the decision of the Supreme Council of Health (SCH) to abolish government controls over the pricing of medicines and to allow more imported goods and suppliers in the country. Qatar has adopted an open market system. The retail prices of medicines remain among the highest in the Middle East.

There is no official policy on the bioequivalence of generic medicines, although the government is promoting their use [3]. Nevertheless, Business Monitor International (BMI) has reported that there is extensive use of branded medicines in Qatar’s healthcare facilities [3]. HMC is using brands mainly because of prescriber’s preference, patient trust and unavailability of a bioequivalence centre in Qatar, where bioequivalence could be studied and tested.

The high share of imported and branded medicines has increased the Qatari government’s healthcare spending. SCH’s attempt to remove price controls affected the affordability of medicines, with the prices of some drugs increasing and becoming inconsistent across facilities. The government has had to implement price controls, although it abstained from explicitly fixing prices.

Qatar’s pharmaceutical market is not able to support its own needs and is likely to remain highly import-dependent, providing significant opportunities for multinational branded drugmakers to penetrate the market. Although the government tends to purchase branded products, the share of the market taken by generic drugs is increasing [3].

There is no national list of approved drugs with therapeutic equivalence, as seen in the US with the Food and Drug Administration’s Orange Book [4]. Anecdotal evidence indicates that, due to preference and cultural aspects, both clinicians and patients prefer to use branded medicines, and the use of generic drugs is low. This has contributed to additional healthcare costs that could have been avoided. Under the National Health Strategy 2011–2016 (Project 5.4), the government has focussed on generic medicines use and awareness in the country. SCH has proposed several behavioural and utilization studies to assess the generic medicines issues among public and healthcare providers, i.e. levels of utilization, perception, knowledge, practice.

It is estimated that the value of Qatar’s drug expenditure at consumer prices in 2009 was Qatari Rial 848 million (US$233 million), having posted double-digit growth in relation to the previous year [5]. Further, according to BMI, prescription drugs continued to dominate the market, accounting for close to 90% of sales by value [5]. By 2014, drug expenditure is forecast to increase by a compound annual growth rate of 11.16%, in both US dollar and local currency terms, as the latter is linked to the former, to reach Qatari Rial 1.44 billion (US$400 million) [5].

The World Bank warns of the impact of poverty and the huge disparity in wealth in the Middle East [6]. Wealthy individuals in the region are needed to invest their resources in projects to reverse this trend, such as by funding pharmaceutical companies to produce generic medicines for the marginalized and poor in the region. In that way, Arabs could bridge the gap between the extremely wealthy and those who lack essential medicines, by removing the reliance on sustained imports of branded medicines. This reliance is currently the case in all Arab countries, especially the six GCC states.

Multinational pharmaceutical companies have been successful in the Qatari market due to high brand consciousness of patients and prescribers for both prescription and over-the-counter medicines. But there is little interest in setting up manufacturing plants in Qatar due to the small market size. Instead, Qatar prefers to import medicines especially from western countries including Europe, UK, USA, and a small proportion from the Middle East and North African countries and Asian countries.

Acknowledgements

The author wishes to thank the English editing support provided by Bea Perks, PhD, GaBI Journal Editor for this manuscript.

Competing interests: None.

Provenance and peer review: Not commissioned; internally peer reviewed.

References
1. National Health Strategy 2011–2016 Supreme Council of Health, Qatar [homepage on the Internet]. [cited 2015 Jan 28]. Available from: http://www.nhsq.info/strategy-goals-and-projects/national-health-policy/healthcare-products-regulation/news-details?item=81&backArt=286
2. General Secretariat for Development Planning of Qatar. Qatar National Vision 2030, Doha, Qatar. July 2008 [homepage on the Internet]. 2008 Jul 27 [cited 2015 Jan 28]. Available from: http://www.gsdp.gov.qa/www1_docs/QNV2030_English_v2.pdf
3. Business Monitor International. Qatar pharmaceuticals & healthcare report Q3 2013. 31 Jul 2013. [cited 2015 Jan 28]. Available from: http://www.rnrmarketresearch.com/qatar-pharmaceuticals-and-healthcare-report-q3-2013-market-report.html
4. U.S. Food and Drug Adminstration. Orange Book: approved drug products with therapeutic equivalence evaluations [homepage on the Internet]. 2015 [cited 2015 Jan 28]. Available from: http://www.accessdata.fda.gov/scripts/cder/ob/
5. Business Monitor International. Qatar pharmaceuticals and healthcare report Q2 2010.
6. Jaber KA. The widening gap between rich and poor in the Arab world. The Peninsula. 20 October 2010. Available from: http://thepeninsulaqatar.com/qatar-perspective/khalid-al-jaber/129823/the-widening-gap-between-rich-and-poor-in-the-arab-world. Accessed 28 January 2015.

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