Ahmed Moustafa outlines the incredible development of the healthcare ecosystem in the UAE driven by a rapid ramping up of the country's health infrastructure and a willingness on the part of the authorities to enter into partnerships with leading private sector players like Amgen. He also touches on the major healthcare challenges across the Gulf region he leads, and the synergies to be leveraged to drive better outcomes for patients.
Can you tell us about your career over the past few years, and your experience of managing the Gulf cluster through COVID-19?
I am an Egyptian pharmacist with more than 25 years of diverse experience across various pharmaceutical companies and geographies and a great passion for serving patients. Prior to my current role, I managed Amgen’s operations in Egypt and Iran, two densely populated countries with tremendous ambition and the associated healthcare challenges that arise when you combine both.
Upon embarking on the journey of managing the Gulf countries for Amgen back in 2019 and making the move to Dubai, I was pleasantly surprised with the status and achievements of the UAE compared to 2008, the last time I lived and worked here.
I was impressed with two main points. First, the mindset of the authorities in the UAE. They view healthcare as an investment and a key enabler for economic growth, prosperity, and resilience. This mindset is agile and empowers exploring novel approaches.
Second, the incredible development of the country’s healthcare infrastructure. The overall investment in healthcare and the innovation associated with it in the UAE was significant. Both the private and public sectors have developed well, and some of the best hospitals in the world are present in the UAE. These positive attributes also came with the challenges of navigating the differences between private and public health insurance in the UAE, so I had a lot to learn.
In moving from a large, resource-constrained environment to a smaller and much more developed market, how have you had to adapt your strategy?
When I moved back to the UAE, I examined the main characteristics of the market and looked for areas of leverage that align with areas where Amgen can bring value and better serve patients. In the UAE, those characteristics are its innovativeness, the solid infrastructure of the healthcare system, and the willingness of authorities to partner with stakeholders.
The UAE’s drive to bring new innovations to market quickly is backed up by a well-developed regulatory system and a transparent and reasonable pricing system that enables rapid registration. Decision-makers are proactive and well-informed, and authorities are abreast of cutting-edge innovation and recent scientific developments. This encourages us at Amgen to prioritize the UAE in terms of bringing innovation and incentivizes investment. In fact, Amgen registered a lung cancer medication in the UAE just 12 days after receiving FDA approval, making it the first country in the world, after the U.S., to make this product available to patients.
The UAE authorities are willing to listen and are open to entering into partnerships, adopting global best practices, continuously enhancing policies to embrace new technologies and innovation, and quickly reacting to changing dynamics. During the pandemic, this was demonstrated quite strongly by the quick actions the authorities took to navigate the challenges COVID-19 imposed, including that patients were confined at home and couldn’t properly access healthcare or medication. They adjusted the processes and collaborated with us at Amgen, among others, to help deliver medicines to patients at home.
Identifying these characteristics allowed me to better understand the needs of the market and to develop strategies that are aligned with the UAE’s goals for healthcare.
Can you expand on how this willingness to listen has manifested in partnerships and collaborations in the UAE?
Derived from the UAE authorities’ and Amgen’s common understanding that healthcare is an investment and that public-private partnerships are key enablers to building a resilient, strong, and innovative healthcare ecosystem, we continuously partner to find creative solutions to complex challenges.
As an example, there is a challenge in the private sector in the UAE since insurance companies do not yet fully cover all expats. Drawing on Amgen’s mission to serve patients and our positioning as a leading biotechnology company in the prevention, prediction, and management of serious diseases, we partnered with the healthcare system to create patient assistance programs for critical illnesses including cancer and cardiovascular disease. This collaboration resulted in expanding access to Amgen’s lifesaving medications to more than 100 patients via a third party.
We also partnered with the authorities to support them in navigating their budgetary challenges. To this end, we provided a health economic model to identify the right patient profile, enhance treatment outcomes and leverage fact-based decision-making to ensure investment is made in the right place.
On the oncology front, we are expanding the scale and diversity of our human omics platforms to move towards a precision medicine approach to drug discovery and development.
You lead the Gulf countries, what are some of the commonalities and how do you leverage them?
I lead five countries: the UAE, Kuwait, Qatar, Oman, and Bahrain. While their respective healthcare structures differ, there are many commonalities among them, including similarity of disease prevalence and associated burden, as well as a high level of cross-country collaboration and experience sharing.
As a result of genetic and lifestyle factors, the prevalence of specific diseases such as cardiovascular disease (CVD) and osteoporosis in the GCC region is alarming and rising.¹ ²
CVD is the leading cause of death in the Middle East and accounts for 40% of total deaths in Oman and the UAE ³¯⁴. In the GCC, research has shown that compared to Western countries, heart attacks occur 10 years earlier and the prevalence of familial hypercholesterolemia is about 3-fold the estimated prevalence worldwide.⁵ ⁶
Osteoporosis, considered one of the major epidemics of the 21st century, affects approximately 200 million people worldwide, with a significant global impact on morbidity and mortality rates, as well as massive socioeconomic burdens. Osteoporosis also shows an alarming rising prevalence in the GCC². A strong emphasis on the importance of an integrative holistic approach in the prevention and early treatment of osteoporosis is required. Lack of adequate awareness about these diseases exacerbates the issue even further.
At the same time, doctors and thought leaders are well connected and exchange knowledge and best practices. At Amgen, we are keen to connect them further and create programs that address common challenges.
As a leader in cardiovascular disease management, we are supporting hospitals in the UAE and Kuwait to create their own treatment protocols for post-myocardial infarction patients. This standardization of care enables better treatment outcomes and prevention of further morbidity and its incurred healthcare spending.
We have also created a program in Kuwait to improve osteoporosis diagnosis, fracture prevention, and management and equip general practitioners with the required knowledge to effectively manage the disease. This program was quite successful and greatly improved the diagnosis of osteoporosis in Kuwait. It was shared in forums with other Gulf countries, and as a result, has been adopted and implemented by Oman and is now replicated in the rest of the Gulf countries.
Is the company’s full global portfolio present in this region? How do you see this moving forward?
At Amgen, we focus on areas of great unmet medical need and where we can provide value. The Gulf is a priority market for us, and we believe that our portfolio can help close the gap in the current disease burden. Therefore, we focus on cardiovascular diseases (CVD), osteoporosis, oncology, haematology, and nephrology.
CVD is the leading cause of morbidity and mortality worldwide and has a leading modifiable risk factor: LDL-C⁷. We focus on continuous scientific education and enhancing dyslipidemia management, as well as introducing solutions that enable healthcare professionals to improve treatment outcomes and support patients in reaching their LDL-C targets.
Worldwide, one in three women, over the age of 50, will suffer a fracture due to osteoporosis⁸, which causes significant disability, yet despite this, there is a large gap in the management and treatment of osteoporosis, especially in the post-fracture setting, with an estimated four out of five patients remaining undiagnosed and untreated after a fracture⁹. As a leader in bone health, we partner with prominent scientific societies to improve the diagnosis and management of this debilitating disease.
Cancer is a growing healthcare issue and despite many remarkable advancements, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths. ¹º
We are committed to bringing innovations to patients with complex cancers, where there remains a significant unmet need to improve outcomes. We do so by partnering with stakeholders to ensure the right patient can access the right treatment at the right time.
Could you detail some ways in which the system in the UAE could progress even further? Where is there still room for improvement?
There is always room for improvement, especially when you start from a solid foundation. The main area of improvement is the variability of access to medications in the UAE, as there are different types of reimbursement schemes. For example, the public sector covers a specific group of patients, while the private sector covers another via variable tiers of insurance.
We are continuously partnering with healthcare authorities to create patient assistance programs to reach and serve more patients and enhance the quality and standard of care, as well as patient support programs, to improve patient education and adherence to therapy and enable home administration.
How do you view digitization and artificial intelligence (AI)? What is the significance of the digitalization piece for Amgen in the UAE?
AI is of significant importance and there is a great need and value in implementing it including in biotech. AI is being used to deploy efficient and precise inventions that will help patients suffering from different diseases. In the UAE, there are two fields of AI that Amgen can collaborate with the authorities on: early detection and improving diagnosis accuracy of diseases as well as clinical trials. In the latter, AI can be leveraged to enhance patient selection which will lead to faster trial recruitment and conduction as well as enhanced treatment outcomes and results.
Examples of innovative digital tools are Malaffi in Abu Dhabi and Nabidh in Dubai, which are electronic medical records systems that include data of millions of patients and approx. 100 thousand clinicians are utilizing both platforms. Through those innovative tools, previous paper records, including each patient’s full medical history, have been digitized. These records, combined with AI applications, could predict diseases like CVD and prevent cardiac events by initiating treatment early on.
I am optimistic about the UAE’s advancement in digital in general and in AI in particular. This has been proven by many previous examples, and when you combine this history with the country’s view of healthcare being an investment, the opportunities are endless.
When you look back on your time at Amgen Gulf, what are you most proud of?
My sense of pride is linked to our mission to serve patients. My team and I are fortunate to be able to make an impact, reach patients, and bring value to our stakeholders, the healthcare ecosystem, and societies at large.
In 2022 alone we have reached around 50, 000 patients and were recognized as “Best Partner in Hematology” from the Emirates Hematology Society and “Industry Researcher of the Year” from the Emirates Oncology Society among other recognitions.
This was only possible because of the incredible team of over 15 nationalities at Amgen Gulf. Amgen’s goal is to foster a culture of belonging, where diverse talent is widely represented, and everyone feels welcome. This commitment to diversity has resulted in an impressive representation of women within our organization. Our entire staff, including leadership, is 50% female, well above the MENA average of 19%. We also continuously focus on staff development and providing career growth opportunities, and we seek to create a safe space where each team member can thrive and reach their full potential. I’m also proud that we have been certified as a “Great Place to Work” and “Best Workplaces.” Additionally, Amgen Gulf has been listed as one of the “Best Workplaces for Women.” I am confident that our team will continue to grow and further establish Amgen as an industry leader in the region.
Do you have a final message for our international audience?
I am optimistic about the Gulf countries and the Middle East in general. I believe this is a region with diverse talents, a relentless drive for progress, and tremendous opportunities for growth.
References
1-The Burden of Cardiovascular Disease Risk Factors in the Middle East: A Systematic Review and Meta-Analysis Focusing on Primary Prevention. Current Vascular Pharmacology, 19(4), 379–389.
2- An insight into the paradigms of osteoporosis: From genetics to biomechanics. Bone Reports, 11, 100216.
3-Cardiovascular health research priorities in the United Arab Emirates. Frontiers in Public Health, 11.
4-https://world-heart-federation.org
5-Management and outcomes of Middle Eastern patients admitted with acute coronary syndromes in the Gulf Registry of Acute Coronary Events (Gulf RACE)
6-Familial Hypercholesterolemia in the Arabian Gulf Region: Clinical results of the Gulf FH Registry
7- The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health.
8- International osteoporosis foundation.
9- Osteoporosis: underrated, underdiagnosed and undertreated
