Healthcare in Egypt

For several decades, the government has provided a subsidized healthcare system that is meant to ensure health care for those who cannot afford it.

[1] The system relies on four distinct financial agents, including the government and the public sector as well as private organizations and out-of-pocket payments made by individuals and families.

Statistics show that the private sector is the initial choice of a healthcare provider in Egypt, even among the lowest income groups.

Despite improvements in health indicators over the last decades, such as an increase in life expectancy from 64.5 to 70.5 years,[14] challenges remain in healthcare financing.

The Total Health Expenditure (THE) in Egypt, as a percentage of the Gross Domestic Product (GDP), has been relatively stagnant, ranging between 3.0% to 7.0% over the past 12 years, with a median of 5.5%.

This high proportion of OOP expenses poses a significant financial risk to families, potentially leading to catastrophic health expenditures and poverty.

[15] In response to the challenges posed by the high OOP expenses, the Egyptian government is moving towards implementing Universal Health Insurance (UHI) to provide comprehensive healthcare coverage to the entire population, aiming to reduce financial hardships related to healthcare expenses.

This initiative is expected to significantly alter the landscape of healthcare financing in Egypt, with a phased implementation planned to be completed by 2032.

With an increasing population and changing socioeconomic environment, Egypt faces great challenges in adapting to such developments in terms of healthcare facilities.

Although the system ensures basic universal coverage, it faces several shortcomings in terms of quality of service due to underfunding.

The Universal Health Insurance Law also attempts to extend healthcare coverage to a wider portion of society, rather than on a case-by-case basis.

The proposed roadmap with specific actions aims to establish a successful HTA structure and related activities in the country.

This includes a focus on innovative pharmaceuticals with significant budget impact, with future expansion to additional technologies within the scope of HTA.

[36] Egypt, as a lower-middle-income country with a population of approximately 102 million, is undergoing significant changes in its healthcare system.

Experts recommended enhancing HTA and health economics capacity through more postgraduate programs tailored to country-specific needs.

[36] For the assessment and critical appraisal aspects of HTA, private funding through submission fees is viewed as the most feasible option for the next decade.

The approach recommends a balanced funding model for critical appraisals, combining public and private sources.

[36] The decision-making process should utilize cost-effectiveness and budget impact analyses, alongside other criteria like multi-criteria decision analysis (MCDA) for tenders, especially for off-patent pharmaceuticals.