Presentation (CTI)

OBJECTIVES: Market access agreements, named as alternative reimbursement models, in Turkey are beneficial for both reimbursement institutions and pharmaceutical companies. This study aimed to evaluate medicines included in reimbursement under the Alternative Reimbursement Commission (AGÖK) between 2016 and 2026 in terms of annual distribution, reimbursement list status, ATC classification, indications, orphan drug status, and changes in list prices.
METHODS: Medicines covered by AGÖK were identified through a review of relevant Official Gazette decisions. Data were obtained from the Health Implementation Communiqué annex lists (4A/4C), ECONALiX databases, and the Turkish Pharmacists’ Association database. The data were transferred to Excel and analyzed descriptively.
RESULTS: Between 2016 and 2026, a total of 113 medicines were included in reimbursement under AGÖK. As of 2026, 90 of these medicines were listed under 4A and 23 under 4C. In addition, 22 of the 113 medicines were initially included under AGÖK but were later transferred to IGÖK. According to ATC classification, the most common group was Antineoplastic and Immunomodulating Agents (Group L).The most frequent indications among AGÖK-covered medicines were non-small-cell lung cancer, melanoma, and multiple myeloma. Oncology medicines constituted the majority of the included medicines, while 56 medicines were classified as orphan drugs used in rare diseases. A total of 47 medicines experienced a decrease in list price, with an average decrease rate of 24%. In contrast, 13 medicines experienced an increase in list price, with an average increase rate of 49%. Annual reimbursement approvals fluctuated over the study period, with the highest number recorded in 2018.
CONCLUSIONS: AGÖK remains an important mechanism for enabling access to oncology and orphan medicines in Türkiye. The findings suggest that the alternative reimbursement scheme may support patient access while also contributing to cost containment.