In the coming years, Turkey plans to prioritize R&D initiatives, health studies and medical innovation: that’s the core message Minister of Health Mehmet Müezzinoğlu gave PharmaBoardroom.
This is the beginning of a new era for healthcare in Turkey. The twenty-first century has already been a period of change in the country. The period was defined by the Healthcare Transformation Program (HTP), which saw the complete overhaul and expansion of the Turkish Healthcare system between 2003 and 2013, with three separate social security agencies combined into a unified social security institution (SGK). During the same period the private sector was expanded and brought into the national reimbursement system, and more than 98 percent of Turkey’s population were brought under national insurance coverage.
This transformation caused pharmaceutical sales volumes to skyrocket at a 9.6 percent CAGR between 2003 and 2013, according to the Turkish Drug and Medical Devices Agency (TITCK). The reimbursement rate increased to more than 95 percent, and patient access to healthcare services and general healthcare awareness improved each year. Of course, achieving this status quo came at a price, and after seeing healthcare expenditure begin to rise rapidly in the late 2000s, the government offered aggressive public discounts in 2009 and 2011 to contain spending. As such, pharmaceutical expenditure grew by just three percent in real terms over the same period.
Having reached the end of this transformational era, Turkey is set for a different kind of progress. This new era will provide an opportunity for industry associations to play a role in developing the government’s new strategic plans in the pharmaceutical industry. Murat Barlas, chairman of Liba Laboratories and the senior board member of the Pharmaceutical Manufacturers Association of Turkey (IEIS), explains that “the current plan for the pharma sector until 2023 was prepared by the industry and delivered to the government.”
This plan was published by the association in November 2011, in a report entitled ‘Partnering with the Government to Globalize the Turkish Pharmaceutical Industry,’ while the AIFD published a similar strategy document in 2012 titled ‘Turkey’s Pharmaceutical Sector Vision 2023 Report’, and the two garnered enough attention that several items from their action plan surfaced in the government’s own plans, including the national Tenth Development Plan.
“Going forward, we will be prioritizing R&D initiatives, including health studies and medical innovation,” details Akdağ’s successor, Minister of Health Mehmet Müezzinoğlu. “It is for this purpose that we founded the ‘Department of Health Institutions of Turkey’, which will follow developments in medicine closely. The Ministry of Health is encouraging the production of medical devices and medications in Turkey, and we will be supporting the development of vaccines, biosimilars, and other high value added medicines in Turkey.”
Article 1.16 of the Tenth Development Plan outlines a ‘structural transformation program within the health industry,’ and includes the target for 60 percent of pharmaceutical products and 20 percent of medical devices consumed in Turkey to be produced domestically by 2018. Other targets for the healthcare and pharmaceutical industries have been set under the auspices of President Recep Tayyip Erdoğan’s ‘2023 Vision’, a set of goals for the country to achieve by the 100th anniversary of the Republic of Turkey’s foundation in 1923, which include aggressive targets for increasing exports and improving competitiveness for R&D investment.
While much progress is being made, questions remain regarding the feasibility of achieving these goals, and the effectiveness of the initiatives that have been introduced thus far. “The vision that the government has for the pharma sector will be achievable only if it changes its perspective on the industry as it stands,” argues Barlas. He explains that “today, for our government, the most important issue is the cost of healthcare and pharmaceuticals… if this perspective shifts and we are able to communicate our needs better to the government, then achieving this vision may yet be attainable.”
Yet, much progress is being made across the industry with numerous biosimilar development projects underway, and other investments in higher-value manufacturing activities taking place. In fact, while “some existing policies are still contradictory to this 2023 vision,” Pfizer country manager Elif Aral alleges that “the government has made it clear that they will support the industry moving forward, and not continue to treat it as a cost that must be contained.”