EXPERT MEETING 2026
Advancing UTI Management: Addressing Unmet Needs and Access to Innovative Antibiotics
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SECTION 1 - Participant & Organizational Context
1. Your role:
*
Medical Director
Pharmacy Benefits Lead
Utilization Review Lead
TPA Medical Team
Other
Other (specify)
2. Organization type:
*
Insurance payer (direct)
TPA
Health system
Integrated network
3. Which emirates do your coverage policies mainly apply to?
*
Abu Dhabi
Dubai
Northern Emirates
All
SECTION 2 - Current Reimbursement Reality for Antibiotics
1. How would you describe your organization’s current approach to oral antibiotics for outpatient uncomplicated UTI?
*
Broadly open access
Covered but controlled (e.g., diagnosis based restrictions)
Controlled for newer/expensive antibiotics only
Highly restricted
2. What are the top 2–3 reasons outpatient oral antibiotics face claim rejections in your system?
Incorrect diagnosis code
Missing justification
High price
Plan exclusion
Stewardship / inappropriate prescribing concern
Other (specify)
Other (please specify):
SECTION 3 - Pricing & Premium Antibiotic Acceptance
3. What is your general view on higher priced oral antibiotics in outpatient settings?
*
Acceptable if clinically differentiated
Acceptable only after failure of cheaper alternatives
Only acceptable in special cases (comorbidities, recurrences)
Not preferred; likely to face restrictions
4. Please rate how acceptable the following would be for approving a new (premium priced) antibiotic: (1 = Not acceptable, 5 = Fully acceptable)
*
Prior failure of 1 antibiotic in last 6 months
Selected Value:
0
Prior failure of 2 antibiotics in last 12 months
Selected Value:
0
Specialist prescription (e.g., Urologist, Infectious Disease)
Selected Value:
0
Documentation of culture or E test
Selected Value:
0
Payment 2. 6
High resistance in local antibiogram
Selected Value:
0
SECTION 4 - Diagnostics & Stewardship
5. Is E test / MIC testing usually covered in your outpatient workflows?
*
Yes, generally covered
Only covered with strong justification
Covered after treatment failure
Rarely or never covered
SECTION 5 - Prior Authorization & Automation
6. How likely would your organization be to require prior authorization for a new premium oral UTI antibiotic?
*
Very likely
Likely
Uncertain / depends on data or price
Unlikely
No, automatic approval preferred
7. Which THREE of the below criteria would have the greatest influence on reimbursement approval? (Select up to 3)
*
Culture-confirmed pathogen resistant to ≥3 antibiotic classes,
Oral treatment exhaustion due to resistance pattern, lack of efficacy or contraindication,
Hospitalization avoidance due to patient preference,
Specialist Prescription,
Alignment with local antimicrobial stewardship protocols/ Guidelines
Other
Other (please specify):
SECTION 6 - Affordability & Co Payment Environment
8. What is the highest co payment amount outpatient patients realistically pay before refusing treatment?
*
< 100 AED
100–300 AED
300–500 AED
500–1,000 AED
Above 1,000 AED is acceptable
Very dependent on condition
9. Does your organization have members who pay 1,000–2,000 AED out-of-pocket for medicines?
*
Yes, regularly
Sometimes, in specialist therapies only
Rarely
Never
SECTION 7 - Benchmarking Experience
10. How familiar are you with the reimbursement journey of newer antibiotics (e.g., Baxdela, Linezolid brands, Zenix, Bactolid)?
*
Very familiar
Somewhat familiar
Limited familiarity
Not familiar
11. If familiar, please mention 1–2 key challenges those products faced at launch: (Open text)
*
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