Definition of value in health in Saudi Arabia

Overview

Health systems today have the common challenge to reform in the face of increasing demands for good care and rising costs. In enacting national health reforms, several countries have turned to the concept of value — a relationship between outcomes achieved and costs incurred to achieve these outcomes — as a goal to be pursued. Porter and Teisberg’s 2006 book, Redefining Health Care: Creating Value-Based Competition on Results, was an important contribution, promoting value-based healthcare as a remedy to the ills of healthcare in the United States. Since 2006, significant further work has been carried out by researchers and governments to apply the concept of value in other countries. What works in health policy is known to be highly dependent on the context in which it is implemented. One should therefore expect the appropriate definition of value to differ from country to country, reflecting the specific current needs and priorities of the nation’s people and government.

Value in Health was established as a national thinktank on value-based healthcare for Saudi Arabia in 2020. One of its first tasks was to determine a national definition of value for Saudi Arabia, around which it could seek to align policymakers and frontline practitioners. In developing this policy perspective, Definition of Value in Health in Saudi Arabia, we reviewed existing frameworks for healthcare value, and convened an expert panel of global and national thought leaders to develop recommendations. The resulting definition sees value in health as achieving the best health outcomes with the optimal and fair allocation and best utilization of resources, where “outcomes” relate to benefits delivered for individual, communities and the population; and “resources” include all human, capital and natural resources. This definition reflects Saudi Arabia’s commitment to universal health coverage, the goals of its health system transformation, and the need to drive value at population, community and individual levels. A broader definition of outcomes and costs is warranted for the Kingdom. Value goes beyond immediate clinical outcomes to measure patient-reported outcomes and wider social benefits, and considers more than merely monetary costs, quantifying non-financial costs such as citizen and clinician time and carbon impact.

A common definition of value is important. But clearly, planning and implementing actions to realize value comes next. All health systems, including those that take a value-based approach to health reform, continue to find it difficult to improve quality and access in a sustainable way while managing resource use efficiently. Value in Health’s mission is to accelerate the transformation to a high-value health system in Saudi Arabia and aligning stakeholders around what needs to be achieved — the national definition of value — is a critical step in this direction.