Shifts in Medicine Reimbursement in Türkiye: Who Pays for Medicines (2015-2022)?
Author(s)
Ekin Begum Ozdemir, MSc1, OZNUR SEYHUN, BSc, MFE, MSc2, Sevval Erdogan, BSc1, Guvenc Kockaya, MSc, PhD, MD1, Selin Okcun, MSc1.
1Econix Research, Samsun, Turkey, 2Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
1Econix Research, Samsun, Turkey, 2Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
OBJECTIVES: The source of pharmaceutical financing is a critical indicator for evaluating the sustainability and accessibility of a healthcare system. In Türkiye, the majority of medications are reimbursed by the Social Security Institution (SGK), while private insurance and out-of-pocket (cash) payments also contribute to the overall picture. This study aims to analyze the trends in pharmaceutical financing in Türkiye between 2015 and 2022 using data from the annual Medicine Monitoring Reports published by the Turkish Medicines and Medical Devices Agency (TITCK), with a focus on the shifting roles of public and non-public payers.
METHODS: This retrospective analysis used data obtained from TITCK’s Medicine Monitoring Reports. The share of pharmaceutical expenditures was examined under three categories: SGK reimbursement, private insurance coverage, and out-of-pocket (cash) payments by patients. Annual percentage distributions were analyzed to observe year-over-year changes and to evaluate structural shifts, especially during the COVID-19 pandemic.
RESULTS: In 2015, 82.01% of medicine expenditures were covered by SGK. This rate declined to 76.57% by 2020, surged to 87.22% in 2021, and then dropped again to 78.00% in 2022. Private insurance consistently accounted for a minor share, ranging between 1.1% and 1.6% throughout the period. Out-of-pocket (cash) payments increased from 16.35% in 2015 to 22.32% in 2020, decreased sharply to 12.06% in 2021, then rose again to 20.07% in 2022. These fluctuations suggest that patients’ financial burden increased notably during the pandemic, followed by temporary relief.
CONCLUSIONS: Between 2015 and 2022, SGK remained the dominant payer in pharmaceutical expenditures. However, the rise in out-of-pocket payments, particularly during the pandemic, reveals vulnerabilities in public medicine coverage. The rebound in SGK’s share in 2021 appears short-lived. These findings highlight the need for consistent public financing strategies and careful monitoring of household healthcare spending.
METHODS: This retrospective analysis used data obtained from TITCK’s Medicine Monitoring Reports. The share of pharmaceutical expenditures was examined under three categories: SGK reimbursement, private insurance coverage, and out-of-pocket (cash) payments by patients. Annual percentage distributions were analyzed to observe year-over-year changes and to evaluate structural shifts, especially during the COVID-19 pandemic.
RESULTS: In 2015, 82.01% of medicine expenditures were covered by SGK. This rate declined to 76.57% by 2020, surged to 87.22% in 2021, and then dropped again to 78.00% in 2022. Private insurance consistently accounted for a minor share, ranging between 1.1% and 1.6% throughout the period. Out-of-pocket (cash) payments increased from 16.35% in 2015 to 22.32% in 2020, decreased sharply to 12.06% in 2021, then rose again to 20.07% in 2022. These fluctuations suggest that patients’ financial burden increased notably during the pandemic, followed by temporary relief.
CONCLUSIONS: Between 2015 and 2022, SGK remained the dominant payer in pharmaceutical expenditures. However, the rise in out-of-pocket payments, particularly during the pandemic, reveals vulnerabilities in public medicine coverage. The rebound in SGK’s share in 2021 appears short-lived. These findings highlight the need for consistent public financing strategies and careful monitoring of household healthcare spending.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR182
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas