As Egypt moves towards universal healthcare coverage for its 100 million-plus population, the country has become the fastest growing pharma market in the Middle East and Africa region with a value of USD 6.3 billion. Here are some of the key trends to watch in Egypt as identified by local industry stakeholders.
Taking advantage of sweeping transformation
Under the umbrella of its Vision 2030 economic transformation plan, Egypt is making strides towards covering its over 100 million citizens through a universal healthcare insurance scheme that has already been rolled out on a pilot basis in certain areas of the country. The industry is feeling the positive impact of this far-reaching transformation that is overtaking the nation’s healthcare landscape and creating opportunities for the pharma industry.
“Not many countries in the MEA region have such a large population and an ambitious healthcare transformation program. These two factors mean that Egypt represents a key opportunity,” says Mohamed Nasser, General Manager, Amgen Middle East & Africa.
The current healthcare transformation could bring 100 million people under the umbrella of universal health insurance, thus growing the market extensively
Sherif Amin, Country President of Novartis Egypt, correlates the expansion of coverage to broad market growth: “The current healthcare transformation could bring 100 million people under the umbrella of universal health insurance, thus growing the market extensively. The government is aiming for quality and innovative treatments, which come at a cost, but funds have been allocated towards this aim and there is an overall willingness to progress.”
“We are now living in the best time for healthcare provision in Egypt in terms of positive change, appreciation of the value of innovation and genuine interest from decision makers to improve patients’ lives, says Mohamed Swilam, General Manager, Roche Egypt.
“For companies in the business of developing and providing effective treatments, this is a huge opportunity,” Marianne Abou Elkheir, General Manager & Head of Human Pharma, Levant, Iraq, North-East Africa & Sub-Saharan Africa at Boehringer Ingelheim asserts.
One of the government’s key decisions in rolling out its transformative plan has been to create new government agencies to provide more transparency and a clearer distribution of duties. “What we have seen so far is that the authorities have chosen a very scientifically driven process. Their approach has been to distribute responsibilities across different agencies to provide clarity for all stakeholders. We now have the Egyptian Drug Authority (EDA) and the Egyptian Authority for Unified Procurement, Medical Supply, and Technology Management (UPA), which means a separation of duties,” says Samy Khalil, Country Head, Takeda Egypt.
According to Nasser, pharma companies will have a part to play in making the new system work: “Several new governmental organisations have sprung up in Egypt, all of which have clear missions. Pharma needs to connect the dots between these organisations and understand the decision-making process to reduce system redundancies and streamline to a common approach.”
Through direct presidential directives, the country has made an effort to tackle a number of critical disease areas, rolling out campaigns in areas such as hepatitis C and breast cancer.
“Change needs time, but the government has taken the initiative on many projects, like the presidential initiative for Hepatitis C where Egypt became the first country to go from approximately 12 million patients to zero and this progress has been acknowledged by many healthcare organisations, profiling us as a trendsetter in the matter,” says Amin.
Of Novartis’ collaboration in the national breast cancer campaign, he claims: “Another major initiative from the government has been the Women’s Health Initiative, with a focus on breast cancer, in which Novartis has been a key player from day one, working with the government, healthcare professionals, and education and bridging innovation to create new unified protocols to be used on a national level.”
Partnerships: the name of the game
Industry stakeholders are striving to establish partnerships with local authorities, driving the country’s objectives forward and creating opportunities for the industry.
The Hepatitis C campaign was a good example of the local-multinational collaboration needed to reach millions of patients, where global pharma companies did a great job in transferring technology and patents over to local firms
“The Hepatitis C campaign was a good example of the local-multinational collaboration needed to reach millions of patients, where global pharma companies did a great job in transferring technology and patents over to local firms, as this was the suitable approach for this issue,” says Nasser.
Swilam states of Roche’s commitment to establishing these alliances: “We are proud to work closely and collaboratively with the Government of Egypt to support the evolution of the healthcare system. We are partnering in areas such as digital transformation, data generation, provider education, value-based evaluation, and procurement [and specifically] we are working closely with the authorities on the development and roll-out of a Health Technology Assessment (HTA), which can be a valuable tool to ensure that the limited resources of the healthcare system are spent in an efficient way.”
Khalil goes as far as to say that partnerships with industry were at the root of the country’s healthcare revolution: “If we look at the universal healthcare law that kicked off the country’s effort, we can see that the government chose to partner and listen to the private sector, seeing it as a key ally.”
The country’s increased coverage, along with a number of other factors, such as a growing middle class and increased government awareness of the importance of health, have led to considerable market growth. “The pharma market keeps growing and is estimated to rise by 12.3 percent by 2027; three times the average in the Middle East and Africa and well above the global rate,” says Amin.
He further connects the attractiveness of Egypt’s growing market with the authorities’ willingness to partner: “Not only does the Egyptian market’s growth appeal to Novartis, but the fact that the government’s priorities are also high on our priority list means that there are excellent opportunities for partnerships here.”
As in most countries looking to modernize their health systems, data has become a fundamental focus area.
If we begin to use [data] better, then the approach to cost will be enhanced and move beyond simple discounts to a more holistic value viewpoint that considers healthcare an investment and a key driver for resiliency, economic growth, and prosperity
Speaking not just of Egypt, but of the entire region, Nasser claims: “The collection and use of data will be critical for healthcare development in all countries. If we begin to use it better, then the approach to cost will be enhanced and move beyond simple discounts to a more holistic value viewpoint that considers healthcare an investment and a key driver for resiliency, economic growth, and prosperity.”
“Data will also help us see how many patients will benefit, and how to reduce the amount of treatment needed and costs. We are able to do some of this, but still have a long way to go. Novartis is aiming to get on the big data stage and significantly transform how we operate here,” Amin agrees.
Devaluation of the Egyptian pound
A less encouraging trend effecting Egypt and potentially its pharmaceutical market, is the depreciation of the local currency. According to experts, the Egyptian pound has lost between 20 and 25 percent of its value against the dollar since the beginning of 2022. The value of the local currency has been depreciating since March when the Central Bank of Egypt (CBE) decided to end the fixed exchange rate system, which had led to a devaluation of the Egyptian pound by more than 16 percent.
The International Monetary Fund (IMF) confirmed a negative outlook for the country’s economy, cutting its economic growth forecast for 2023, down from the 4.8 percent projected in July to 4.4 percent. Egypt’s already vulnerable economy, weakened by a wave of inflation, is also, like other stronger economies, suffering the shock waves of the war in the Ukraine. Yet stateholders remain optimistic. “In Egypt, unfortunately, the currency devaluation remains a big concern because market prices are fixed. However, I am very optimistic that with our strong government, our company portfolio and robust team locally and regionally, we will be able to have a positive impact on ensuring we provide breakthrough therapies that can ultimately improve treatment outcomes,” says Abou Elkheir.