Country Report: Turkey

Sep 30, 2012
By Pharmaceutical Executive

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COVER ART BY TURKISH LOCAL ARTIST DENIZ KARAKAYA
In the global theater of business and politics, Turkey increasingly leverages its location as an ideal vantage point where actors can seamlessly move between all things West and East.

An emerging Asian market with a special relationship to the European Union and close ties with the Middle East, Turkey's strategic geopolitical position is a place where multinational players want to be. The pharmaceutical industry is no exception.

With a growing, aging population and a young, highly skilled workforce, Turkey's demographics are also a draw. Economically, the country boasts a GDP topping more than 8 percent in 2010 and 2011 and is weathering the global economic crisis better than many of its European neighbors.


Nihat Ergün, Turkey’s minister of Science, Industry and Technology
The pharmaceutical industry has also enjoyed a wave of expansion. According to IMS, the Turkish pharma market reached USD 9.8 billion in 2011 and experienced 10 percent growth in volume. This has attracted some of the industry's biggest players. In recent years, Novartis, Merck Serono, GSK, Sanofi, and Novo Nordisk have made the country a regional center of operations.

Nonetheless, major national healthcare reforms, drastic price reductions, and market access delays have made Turkey's pharmaceutical market a particularly challenging place the past few years.

But with a new budget period beginning in 2013 and signs that the government may be looking to turn a corner, the industry is preparing for the day when Turkey becomes one of the next big pharma countries.

MAKING UNIVERSAL HEALTHCARE A REALITY


2005 – 2011: TURKISH MARKET GROWTH IN VALUE (IEIS)
Over the past decade, Turkey's healthcare system has been radically reformed. With the election of the Justice and Development Party in 2002, universal healthcare became a top national priority. Sweeping reforms began the following year with the enactment of the Health Transformation Program.

First, the country's three social security schemes were united under the Social Security Institute (SGK). Then, in 2008, the Universal Health Insurance law was passed, aiming to make healthcare widely available. Finally, in 2010, the family practitioner system was implemented, providing low-cost care by local doctors to citizens across the country.


Fatih Acar, president of the Social Security Institution (SGK)
According to Fatih Acar, president of the SGK, the reforms have made "access to healthcare services easier and waiting periods have been shortened." He said that most of the population is now covered and that Turkey is considered the "most expanded healthcare provider country in Europe."

Ayşe Çetinel Sapmaz has been the managing director of Janssen, the pharmaceutical company of J&J, in Turkey for the past 11 years and witnessed the dramatic change in the country's healthcare system. "Access to healthcare has increased dramatically—and this is of course something that we view positively. People are no longer left waiting in queues; they have access to doctors, they have access to treatment. From a societal point of view, things are moving in the right direction," she said.


Alp Sevindik, secretary general and COO of the Research Based Pharmaceutical Companies Association (AIFD)
On the other hand, critics raise concerns that new healthcare policy has led to over-use of the system. Alp Sevindik, secretary general and COO of the Association of Research Based Pharmaceutical Companies (AIFD), explained, "In 2002, Turkish citizens would visit a doctor three times a year, on average. However, the numbers of visits have now risen to eight. Of course, most of these visits result in a prescription. Hence, one of the problems we are currently facing is government induced volume or demand. If the government wants to provide this level of quality of health service, the volume of medicine usage will expectedly increase and accordingly, so should the budget to account for that. Unfortunately, that has not been the case."

According to the SGK, expenditures on pharmaceuticals increased from TRY 7.8 billion (USD 2.3 billion) in 2004 to TRY 15.8 billion (USD 8.7 billion) in 2011.