OBJECTIVES

: As a result of Turkey’s healthcare reforms initiated in 2003 access to medicines increased rapidly what enlarged the public medicine expenditure. Simultaneously, costs of unlicenced or unmarketed licenced medicines became greater.The goal of this study was to describe the impact of direct imported medicines on the total public medicine expenditure. The results were compared with Kazakhstan and Poland

METHODS

: The reimbursement system of Turkey was assessed focusing on the mechanism of imported medicines.The MBFA list and sales data from Turkish Pharmacist Association (main provider for direct import medicines in Turkey) were used for the study. The sales data of 10 selected for the study products that contribute to the highest expenditure in Turkey were obtained from Polish and Kazakh MoHs.

RESULTS

: The direct imported medicines constitute to the 8% of the total public pharmaceutical spendings in Turkey. In contrast,this was only possible for orphan medicines in Kazakhstan. In Poland the analyzed products are reimbursed (5 out of 10) within Drug Programmes. In addition a target import and special named patient program exist for life saving therapies. The study shown that 9 products had an orphan indication and contributed to 500 million € costs in Turkey. The public expenditure were lower in Kazakhstan and Poland

CONCLUSIONS

: Direct import of medicines has quite significant impact on the total costs for medicines in Turkey.Other countries in the region,such as Kazakhstan and Poland,that do not use the system of direct import for all medicines have much lower number of patients and associated costs for these products. There is a need to introduce new policy concerning the use of unlicenced medicines for instance by creating HTA Agency. In addition solutions for providing orphan drugs to patients should be created to ensure a sustainable and fair access to therapies on future.