# Optimizing Oncology Generic Medication Selection in the Gulf Region: Expert Consensus and MCDA Tool Development

## TL;DR

This study identifies key factors for selecting generic cancer drugs in the Gulf region, aiming to improve access and affordability while ensuring quality and regulatory compliance.

## Contribution

The study introduces a multicriteria decision analysis tool and expert consensus framework for selecting generic oncology medications in the Gulf region.

## Key findings

- Manufacturing quality was identified as the most critical factor (30.8%) in selecting generic oncology medications.
- Cost (20%) and use in reference countries (14.6%) were also significant factors in the decision-making process.
- The study highlights the need for improved regulatory frameworks and pharmacovigilance to support generic drug adoption.

## Abstract

Background: Cancer remains a leading global health challenge, with high mortality rates and increasing financial burdens on healthcare systems. In the Gulf Cooperation Council countries, generic oncology medications offer a cost-effective alternative to patented treatments. However, disparities in regulatory frameworks and concerns about quality and supply reliability hinder their widespread adoption. Addressing these challenges is crucial to ensuring optimal access to oncology treatments. Methods: This study employed multicriteria decision analysis to evaluate key factors influencing the selection of off-patent oncology drugs. A structured survey was conducted among 10 formulary management experts from the United Arab Emirates, Qatar, Kuwait, Bahrain, and Oman. Participants engaged in a 3-hour workshop to assess and prioritize critical decision-making criteria through guided discussions, case studies, and weighting surveys. Results: The analysis identified manufacturing quality (30.8%), cost (20%), and use in reference countries (14.6%) as the most critical factors in selecting generic oncology mediations. Supply reliability (13%), regulatory aspects (8%), and pharmacovigilance services and extra services (6.8% each) also played supporting roles. The structured evaluation framework developed through this study provides insights into the factors shaping formulary decisions in the Gulf Cooperation Council region and highlights areas requiring regulatory and logistical improvements. Conclusion: This expert consensus underscores the need for a balanced approach that ensures quality, affordability, and accessibility in adopting oncology generics. Strengthening regulatory frameworks, improving pharmacovigilance, and enhancing stakeholder education are essential steps to optimizing the integration of oncology drugs into regional healthcare systems. These findings provide a foundation for policy recommendations aimed at improving generic drug adoption and patient outcomes in oncology care.