Presentation (CTI)

OBJECTIVES: This study aims to analyze structural changes in Türkiye’s pharmaceutical portfolio between 2020 and 2025 using the most recent versions of the Detailed Drug Price List (DİFL) and the 4A Reimbursement List published each year. The focus is on assessing yearly drug counts, ATC group distribution, equivalent group codes, and changes in therapeutic reference groups.
METHODS: Datasets were constructed using the latest available versions of DİFL and 4A lists for each year. Annual total drug counts were calculated, and inter-year comparisons were made. From the DİFL, only ATC codes and groups were used, and the number of drugs per group was examined annually. From the 4A list, equivalent group codes (E and H) and their associated drug counts were evaluated, and non-equivalent drugs were also identified. Yearly changes in Therapeutic Reference Group (TRG) codes were also analyzed.
RESULTS: The total number of drugs in the DİFL decreased from 14,591 in 2020 to 10,996 in 2025. Similarly, the 4A list dropped from 9,010 to 8,524. The ATC groups with the highest number of drugs were N (nervous system), A (alimentary tract and metabolism), B (blood and blood-forming organs), J (anti-infectives), and C (cardiovascular system). E group codes ranged from 1,966 to 2,142, showing general stability. H codes remained limited, between 46 and 50. The number of drugs within equivalent groups showed minor variation. In contrast, non-equivalent drugs declined from 1,370 in 2020 to 1,129 in 2025. TRG codes increased from 107 to 146 during the same period.
CONCLUSIONS: The results indicate notable structural changes in Türkiye’s pharmaceutical market over the past five years. The consistent share of major ATC groups, the stability of the equivalence system, and the growing use of TRGs reflect a structured, evolving, and sustainable policy framework.