Redefining reimbursement policies: A novel value framework for medical nutrition

Abstract

This study aims to review the medical nutrition reimbursement policies in Dubai to facilitate refining of the mandate for inclusion and insurance coverage of nutritional supplementation for specific disease conditions. This study was conducted in two phases, which included a targeted literature review to collect evidence on the use of medical nutrition in target populations (cancer patients, pediatric patients with food and cow milk protein allergy [CMPA], disease-related malnutrition [DRM], and epilepsy) in phase 1 and discussion among the experts from United Arab Emirates [UAE] to review and validate the findings from the literature review and discuss the readiness of Dubai Health Authority (DHA) sector in phase 2 for reimbursement of medical nutrition interventions. Currently, reimbursement for medical nutrition intervention in the private sector is provided on a case-by-case basis in Dubai. Based on the outcomes of pilot projects, the experts agreed to change the mandate for oncology patients and pediatric patients with CMPA. For epilepsy patients, experts advocated the necessity of defined guidelines and recommended the analysis of claims data and establishment of a task force. Effectively formulating guidelines on the use of medical nutrition and using cost-effectiveness models are required to encourage payers to invest in medical nutrition.