Abstract:

Turkey has undergone significant changes on its pharmaceutical policy with Health Transformation Program launched in 2003. For instance, Turkey moved from cost-based pricing system to external reference pricing system, reimbursement commission was fırst established, and positive list was introduced. Then Universal Health Insurance nearly covering whole population was put into practice. From 2003 to 2009, public pharmaceutical spending grew drastically, rising more than 7% annually on average in real terms. As a consequence, Turkish government announced a 3-year global budget on late 2009 along with new copayments for hospital outpatient visits and for prescriptions to reduce excessive utilization and additional rebates to lower drug prices. Those policies were quite successful in curbing overall expenditure, dropping by 28% in real terms in three-year time, as well as roughly 14 billion TL saving. In addition, spending in 2009 hiked to 1.7% of gross domestic product and then dropped to 1% in 2012 and stayed close to 1% in 2013 and 2014. However, Turkey faces new challenges to stabilize spending and increase credibility, transparency, and consistency of its reimbursement decisions. Designing clear methodology on reimbursement decision, revising positive list, developing alternative reimbursement methods such as risk sharing agreements, introducing jumbo pricing, lauching new generic pricing policy and tendering, and incentives for rational drug use will help reach those targets.

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