Multinational R&D investment in Turkey, particularly investment in clinical trials, has been quite limited relative to the size of the Turkish pharmaceutical market.

Turkish R&D spending totaled TRY 14.8 billion (USD 7.77 billion) in 2013, just 0.95 percent of GDP according to TurkStat; President Erdogan’s ‘Vision 2023’ includes the target to increase this ratio to three percent of GDP by 2023. R&D spending on all healthcare related topics has grown at a CAGR of 8.3 percent per year since 2009, reaching TRY 2.217 billion (USD 1.16 billion) in 2013, with pharmaceutical investment on pharmaceutical clinical trials accounting for only TRY 85 million (USD 45 million).

One of the major limiting factors for pharmaceutical R&D investment in Turkey is the small number of certified clinical trial research centers capable of carrying out early phase trials; in a country of 75 million, there are only six such centers, with one of them only being opened in May 2015.

As such, Turkey is not particularly competitive in R&D when compared to countries with robust, often government funded, research infrastructure, and as such the ratio of pharmaceutical R&D spending to pharmaceutical expenditures in Turkey is low relative to many other countries. According to AIFD chairman and GSK VP and Area GM Emin Fadıllıoğlu, “our level of investment in R&D is USD one billion lower than it would be if our R&D share matched our share of [global] expenditures.”

At present, the Tenth Development Plan includes targets to increase the number of clinical trial centers to 13 by 2018, and “to increase the number of clinical trials by 25 percent each year until 2023,” according to TITCK president Özkan Ünal.

Lundbeck Turkey general manager Şebnem Girgin indicates that the company has “been extremely satisfied with the quality of the neurology and psychiatry centers in Turkey when it comes to R&D cooperation, and we have identified a few as key centers for future global studies in this area,” demonstrating that expertise and capabilities do exist to support more investment in clinical trials.

Founded in 1997, the key player in the Turkish clinical trial industry is Omega CRO, the first Turkish CRO, and according to CEO Berk Özdemir, “the only truly full service CRO in Turkey; other local CROs have limited services and outsource work to us.” As he explains, “the Turkish clinical trial area has changed a lot since Omega CRO was founded; at the beginning, we didn’t have a solid regulatory framework, then we had solid regulations but the timelines became too slow, and now we have optimal regulation with optimal timelines.”

Regarding the current clinical trial environment, Özdemir admits Turkey is “still not very competitive, it is difficult for us to substantially increase the number of global trials we can attract… [However], there are some very good projects underway in line with the Vision 2023 goals, and the Ministry of Health recently hosted a workshop in Izmir on how to attract more clinical trials.”

Yet, one multinational has taken a strong interest in bringing high-value R&D activities to Turkey, going beyond clinical trials and bringing basic drug research to Turkey. “AstraZeneca has signed a collaboration agreement with Koç University, that gave us responsibility for preclinical testing and research for a few candidate molecules, as well as access to their broader open innovation chemical library,” according to Burak Erman, head of the Drug Research Center at Koç University.

AstraZeneca Turkey’s country president Pelin Eriştiren Incesu explains that “some of the projects have progressed very well, and the Turkish scientists involved have travelled to AstraZeneca HQ in Cambridge to present their findings, and we remain confident that one or two of these projects will proceed to the clinical development phase, and maybe become the first drug of Turkish origin in the coming years.” AstraZeneca’s support of this project demonstrates that the company is “on the right track to building scientific leadership,” one of the three pillars of AstraZeneca’s current global strategy, according to Incesu.