PHSSR Saudi Arabia 2025

of the most advanced digital health technologies, such as paperless clinical documentation, closed- loop clinical work flows and secure IT infrastructure. Nevertheless, a sizable proportion of Saudi Arabia’s health service providers represent low digital maturity, thus impeding certain holistic digital health solutions that target the entire health sector. The National Health Information Centre (NHIC) governs digital health maturity and oversees initiatives to improve the entire health system in the short- and long-term, in line with Vision 2030. As such, NHIC has launched an initiative to establish a national digital health maturity model that will indicate each health care organisation’s digital maturity status and provide a blueprint for enhancing digital maturity. The blueprint encapsulates best practices, recommendations and guidelines from subject matter experts to assist health care organisations in the process of developing digital health maturity. Furthermore, it allows health care organisations to benchmark each other and offers a general insight into the status of digital maturity across various strati fications. New medicines and technologies The Saudi health system is currently undergoing a paradigm shift, wherein the expectations of all stakeholders are moving towards a value-based model. The major drivers of this transition are the development of innovative medicine with promising health outcomes, the ability to digitally capture high-quality health data and the economic burden posed by a limited budget. To aid the smooth transformation, the Saudi Arabian government has identi fied seven fundamental areas of focus: (1) MOC, (2) health financing, (3) private sector participation, (4) workforce optimisation, (5) corporatisation, (6) e-health and (7) health sector governance. These focus areas are interlinked, and their combined evolution can contribute to a more value-based health system. Adopting an appropriate economic evaluation is essential to the e fficient allocation of resources in a health system with a constrained budget. The two most widely used economic evaluations in Saudi Arabia are budget impact analysis (BIA) and cost-effectiveness analysis. BIA is an integral part of the MoH assessment process for novel interventions and formulary inclusion. BIA is especially relevant to formulary ‘class reviews’ performed at regular intervals to ensure that the formulary content remains relevant to national health care needs. Some initiatives that have already been established or initiated involve the adoption of value and evidence in formulary decision-making processes, including pharmacoeconomic evaluation and the adoption of managed entry agreements with a speci fic focus on value-based agreements (VBA). The MoH pharmacy and therapeutics committee is a policy-recommending body that develops formulary systems to ensure access of clinically appropriate, safe and cost-effective medicines, aligned with the roles set by the SFDA. The current formulary review process is comprehensive and includes value-based processes. The five criteria for subjecting a drug to impartial evaluation are: drug information, safety data, published clinical e fficacy data, pharmacoeconomic analysis and local BIA. This comprehensive review process streamlines the inclusion of only relevant drugs, helping health professionals to choose the best available treatment option with desired clinical outcomes and minimal risk. Managed entry agreements (MEAs) promote access to new medicines and technologies in the context of uncertainty regarding cost-effectiveness, real-life clinical bene fit and potential impact on health expenditure. They also promote innovation and R&D in value-adding therapeutic areas. These arrangements use mechanisms such as financial-based agreements, VBAs and, in certain cases, a hybrid of the two to manage the adoption and maximise the cost-effectiveness of new medicines. The majority of MEAs in Saudi Arabia are finance-based agreements, possibly because of the immediate gains they offer to all stakeholders, with no requirement for long and complex monitoring and follow-up of health outcomes. However, the MoH is seeking to shift to more VBAs that prioritise performance and outcome. Therefore, it has developed its first MEA implementation policy to facilitate and regulate the introduction of similar agreements. In addition, multiple hybrid MEAs with 53 Sustainability and Resilience in the Saudi Arabian Health System The Partnership for Health System Sustainability and Resilience