Presentation (CTI)

OBJECTIVES: This study aims to identify structural changes in Türkiye’s reimbursement system over one year, based on the Healthcare Implementation Communiqué (SUT) Annex-4A lists published at the beginning of 2023 and 2024. Only the first lists released each year were considered. The transformation of the system was examined descriptively by analyzing medicines that were added, removed, or updated between the two dates.
METHODS: The SUT Annex-4A lists published on 16 March 2023 and 25 February 2024 were comparatively analyzed. Medicines present in 2024 but not in 2023 were classified as “added,” those found only in 2023 as “removed,” and those present in both years with any parameter changes as “updated.” These groups were evaluated using descriptive statistics based on drug categories, numerical changes, and discount rate adjustments.
RESULTS: There were 8,359 medicines listed in 2023 and 8,399 in 2024. In both years, the largest group consisted of price-protected medicines (2023: 48.6%; 2024: 48.1%), followed by generic medicines (2023: 33.6%; 2024: 34.4%). Between the two lists, 399 medicines were added, 359 removed, and 100 updated. More than half of the added drugs were generic (51.9%), while nearly half of the removed ones belonged to the price-protected group (47.9%). The highest net increase was observed in generic drugs (+77), whereas decreases were seen in original (-8), price-protected (-24), and enteral (-13) groups. Among the updated drugs, 43 had changes in discount rates—most of which occurred in original medicines (n=29)—indicating a regulatory focus on this category.
CONCLUSIONS: Although the total number of reimbursed drugs changed only slightly between 2023 and 2024, the composition of the list underwent significant transformation. The increasing share of generic medicines, along with discount revisions in original medicines and reductions in the price-protected category, suggest that Türkiye’s reimbursement system is managed in a cost-conscious and dynamic manner.