Turkey’s Minister of Health discusses the major achievements of his party in the area of healthcare since 2003, and the key priorities for the country’s healthcare system moving forward.
During AKP’s (Justice and Development Party) incumbency, what were the main policies in health, and what are your priorities for future healthcare policy?
Upon the AKP’s assumption of power, we initiated the ‘Health Transformation Program’ in 2002, which was a very extensive program of reforms and developments in healthcare. In brief, this program involved establishing a well-organized and empowered Ministry of Health, creating a general health insurance system that covers every citizen, and ensuring that patients have easy access to healthcare services. Primary healthcare services were strengthened, a family doctor system was created, and regulations were reformed to improve the productivity of healthcare institutions.
As a result of this program, all citizens can now obtain reimbursed-medicines from every pharmacy, every citizen can build a relationship with a family doctor, and we have reached high standards for emergency healthcare services. Also, ambulatory services now reach every region in Turkey, as we have introduced the use of planes and helicopters.
Going forward, we will be prioritizing R&D initiatives, including health studies and medical innovation. It is for this purpose that we founded the ‘Department of Health Institutions of Turkey’, which will follow the 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 and high value added medicines in Turkey. Our ultimate goal is for Turkey to be a globally important R&D center for pharmaceutical production, and we will improve Turkey’s competitiveness in the pharmaceutical and medical devices sectors.
The Ministry of Health’s priorities also include developing medical tourism, building more city hospitals to create more comprehensive health services, and accelerating awareness initiatives that encourage healthy living.
Given the growth of medical tourism in Turkey, what are the ministry’s objectives in this regard?
Turkey has a well-developed economy, and strong human resources due to our young and well educated population, and these factors, along with cultural and historical factors, have made Turkey one of the most popular destinations for tourism, with over 40 million people visiting our country each year. Since we began to invest heavily in the healthcare sector ten years ago, many healthcare institutions in Turkey are now competitive at the international level in terms of quality. As a well-connected and attractive tourism destination with good infrastructure, as well as high quality and good value medical services, Turkey is becoming an increasingly popular medical tourism destination. The number of visiting patients has been increasing by about 20 percent per year for several years, and in 2014 there were 496,324 people who visited Turkey for the purpose of receiving healthcare services. There are many reasons behind Turkey’s growth as a medical tourism destination; the high standard of health services, doctors with strong global reputations and experience, fair payment policies, and immediately available services. Furthermore, our country is positioned such that one billion people live within a four hour flight of Turkey.
Due to the experience and knowledge required to provide quality medical care, these services can be considered to be high value added services, and as such we have added medical tourism to our tenth Development Plan as a strategic industry. If Turkey can make some small improvements in this field, we are within reach of becoming a leading country in the world for medical tourism.
Considering the 2023 Vision healthcare targets, what is the Ministry of Health doing in order to increase medicine exports?
The Tenth Development Plan comprises four years between 2014 and 2018. In its action plan the article 1.16, ‘Structural Transformation Program within the Health Industry’ aims to develop a structure that is able to produce high value added medicines. In that context, in order to increase the exportation, these actions will take place:
- Bilateral negotiations and protocols will be made in order to ease the technical controls and to simplify the processes of obtaining licenses in export markets
- Target countries’ non-tariff barriers that impede Turkish exporters will be taken into consideration and studies will be made
- We will prioritize the advertisement of Turkish medicines and medical devices in target countries
- We will provide medicine and medical device producers’ efficient support for exportation
- Studies will be done in order to add the licensed products – produced for exportation – to the reimbursement list
Another target for improving the exportation is to make Turkey a member of the Pharmaceutical Inspection Convention and Pharmaceutical Inspection Co-operation Scheme (PIC/S). This will speed up and ease the process so that medicines made in Turkey can be easily exported to other countries that are also members of PIC/S and in that case, this situation will increase the exportation in a positive way and this will change the import-export balance in favour of Turkey.
What is your ministry doing to make the medicine sector grow, and to define its role in the market?
For all the medicines produced in Turkey, in the Tenth Development Plan’s article 1.16, ‘Structural Transformation Program within the Health Industry’:
- All of the medicines that apply for manufacturing in Turkey will be quickly provided a license by the Ministry of Health.
- Social Security Institutions will accelerate the process of adding a medicine into the reimbursement list for the medicines produced in Turkey by making necessary arrangements.
- Investments will be encouraged for medicines and devices (diagnostics and imaging devices) which are not produced in Turkey or which are difficult to obtain and for the electric devices (diagnostic medical device, imaging device etc.) with high added value which are not produced in Turkey or which are not produced enough.
- R&D studies and production will be encouraged in the frame of advanced treatment which includes Advanced Medical Treatment Productions.
In Turkey, can patients reach innovative products? What are the potential reforms, pricing and registry systems?
In the case of a treatment choice that is more favourable, patients – in some specific conditions – can access the innovative medicines even if they are still not licensed. In that case, they just need some special approval. In the matter of pricing the medicines for human use, there are discussions regarding new pricing arrangements, studies are still continuing. For both of the regulations – ongoing or finished – in every step of work, expert opinion is being taken and new decisions are announced to the sector.
In order to provide patients’ trust in the medicines, we set up a new system called İlaç Takip Sistemi (Medicine Tracking System). This innovative system is unique and is being applied successfully only in Turkey. With MTS, we ensure the entire process that medicine passes through; from production to consumption. With that system, our target is prohibiting the use of counterfeit drugs and illegal drugs; prohibiting the forgery of packaging; supporting rational drug use and collecting data about drugs for market control.
What is the Ministry of Health doing to incentivize investment from foreign investors?
It is important that we increase the amount of production with high technology by attracting foreign investors to our country. So, in our Tenth Development Plan, we placed emphasis on the following subjects:
- In the reimbursement and pricing policies and in the authorization process, we will make some regulations and put some implementations in order to value Turkish products (medicine and medical devices) prior to others
- As part of advanced treatment, medicines for advanced medical treatment will be encouraged in terms of production and R&D studies
- The pricing and reimbursement process will be encouraged for sponsors of R&D studies that consider the needs of our country
- We will support investments to medical products that are not produced in Turkey or that are not produced enough
- We will transform Turkey into a regional administration in the medical sector and into a service center in the healthcare services
- We will provide an efficient use of exportation support to medicine and medical device companies