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CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Turkey

Summary

GlobalData, the industry analysis specialist, has released its latest report, “CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Turkey”. The report is an essential source of information on and analysis of the healthcare, regulatory and reimbursement landscape in Turkey. It identifies the key trends in the country’s healthcare market and provides insights into its demographic, regulatory, and reimbursement landscape and healthcare infrastructure. Most importantly, the report provides valuable insights into the trends and segmentation of its pharmaceutical and medical device markets. It uses data and information sourced from proprietary databases, secondary research, and in-house analysis by GlobalData’s team of industry experts.

Turkey’s population stood at approximately 78.74 million in 2015, and is increasing due to a positive balance between the birth and the death rates, as well as longer life expetancy. The pharmaceutical market was estimated at $4.91 billion in 2015, and is expected to reach approximately $5.43 billion by 2020 at a Compound Annual Growth Rate (CAGR) of 2% due to health transformation Program. The medical devices market was estimated approximately $1.59 billion in 2015 and is expected to reach $2.05 billion by 2020, at a CAGR of 4.2%.

The increase in Turkey's phamraceutical market can primarily be attribtued to -
- Improved medical access
- Decline in average price level of the pharmaceuticals
- Increase in the number of pharmaceutical companies

Scope

The report provides information on Turkey’s healthcare, regulatory and reimbursement landscape, and includes -
- An overview of the pharmaceutical and medical devices markets, comprising size, segmentation and key drivers and barriers
- Profiles and SWOT analyses of the major players in the pharmaceutical and medical devices market. The major players covered for the pharmaceutical market are Abdi Ibrahim, Novartis, Pfizer, Sanofi and Bayer. The major players covered for the medical devices market are Baxter, Alcon, Essilor, Fresenius Medical Care and Johnson & Johnson Vision care
- An insightful review of the country’s reimbursement and regulatory landscape, including details of the healthcare reimbursement process, regulatory agencies and approval processes for new drugs
- Detailed analysis of the political and economic environment, including economic indicators, demographics, and healthcare infrastructure and expenditure
- An overview of the opportunities for and challenges to growth in the healthcare market

Reasons to Buy

This report will enhance your decision-making capability by allowing you to -
- Develop business strategies by understanding the trends shaping and driving Turkey’s healthcare market
- Drive revenues by understanding the key trends, reimbursement and regulatory policies, pharmaceutical market segments and companies likely to impact Turkey’s healthcare market in the future
- Formulate effective sales and marketing strategies by understanding the competitive landscape and analyzing competitors’ performance
- Organize your sales and marketing efforts by identifying the market categories and segments that present the most opportunities for consolidation, investment and strategic partnership

Table Of Contents

CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Turkey
1 Table of Contents
1 Table of Contents 7


2 Introduction 18
3 Overview of Pharmaceutical and Medical Device Markets 19
3.1 Pharmaceutical Market 19
3.1.1 Market Overview 19
3.1.2 Pharmaceutical Import and Export 21
3.1.3 Supply Channels 23
3.1.4 Market Segments 24
3.1.5 Major Therapeutic Areas 27
3.1.6 Major Companies 30
3.2 Medical Device Market 74
3.2.1 Market Overview 74
3.2.2 Overview of Top Five Segments 76
3.2.3 Major Players 85
3.3 Market Drivers and Barriers 119
3.3.1 Drivers 119
3.3.2 Barriers 121
4 Market Access 123
4.1 Reimbursement and Payer Landscape 123
4.1.1 Overview of Healthcare System 123
4.1.2 Reimbursement Process 129
4.1.3 Overview of Insurance Providers 131
4.1.4 Patient Share of Healthcare Expenditure 133
4.1.5 Healthcare Price Trends 134
4.1.6 Pricing Policies 135
4.2 Regulatory Landscape 136
4.2.1 Overview of Regulatory Agencies 136
4.2.2 Market Authorization Procedure for Pharmaceutical Products 137
4.2.3 New Medical Device Approval Process 139
4.2.4 Licensing Process for Pharmaceutical and Medical Device Manufacturing 142
4.2.5 Licensing Process for Pharmaceutical Exports and Imports 143
4.2.6 Intellectual Property Rights 144
4.2.7 Clinical Trial Regulations 146
4.2.8 Pharmaceutical Advertising Regulations 148
4.2.9 Pharmacy Regulations 149
4.2.10 Labeling and Packaging Regulations 150
5 Country Analysis 152
5.1 Political Environment 152
5.1.1 Political Structure 152
5.1.2 Analysis of the Current Political Environment 154
5.1.3 Healthcare Policy Initiatives 156
5.2 Economic Landscape 158
5.3 Economic Indicators 159
5.3.1 Gross Domestic Product 159
5.3.2 Gross National Income 163
5.3.3 Inflation 164
5.3.4 Currency Exchange Rate 168
5.3.5 Foreign Direct Investment 169
5.3.6 Foreign Exchange Reserves 170
5.3.7 Trade Balance 171
5.3.8 Government Structural Balance 173
5.3.9 Government Net Debt 175
5.3.10 Major Industries 176
5.4 Demographics 178
5.4.1 Population 178
5.4.2 Education and Literacy 193
5.4.3 Employment 195
5.4.4 Disease Burden 196
5.5 Healthcare Infrastructure 197
5.5.2 Healthcare Parameters 200
5.5.3 Environmental Health 202
5.5.4 Healthcare Personnel 208
5.6 Healthcare Expenditure 212
5.6.1 Overview of Healthcare Expenditure 212
5.6.2 Major Components of Healthcare Expenditure 213
5.6.3 Healthcare Expenditure Distribution 214
5.6.4 Spending in Pharmaceutical RandD 215
5.7 Trade Associations 216
5.7.1 Turkish Pharmacists' Association 216
5.7.2 Pharmaceutical Manufacturer's Association of Turkey 217
5.7.3 Turkish Confederation of Employer Associations 217
5.8 Trade Fairs 218
6 Opportunities and Challenges 219
6.1 Opportunities 219
6.2 Challenges 220
7 Appendix 223
7.1 Abbreviations 223
7.2 Bibliography 226
7.3 Research Methodology 240
7.3.1 Coverage 240
7.3.2 Secondary Research 240
7.3.3 Forecasts 241
7.3.4 Expert Panel 241
7.4 Disclaimer 242

1.1 List of Tables
Table 1: Pharmaceutical Market, Turkey, Revenue ($bn), 2008-2015 21
Table 2: Pharmaceutical Market, Turkey, Revenue ($bn), 2016-2020 21
Table 3: Pharmaceutical Market, Turkey, Imports and Exports ($bn), 2008-2015 23
Table 4: Generic Market, Turkey, Revenue ($bn), 2008-2015 25
Table 5: OTC Market, Turkey, Revenue ($bn), 2008-2015 27
Table 6: Pharmaceutical Market, Turkey, Major Therapeutic Areas by Value (%), 2015 28
Table 7: Pharmaceutical Market, Abdi Ibrahim, Major Products, 2016 31
Table 8: Pharmaceutical Market, Novartis, Major Products, 2016 36
Table 9: Pharmaceutical Market, Novartis, Global, Planned Filings, 2015 37
Table 10: Pharmaceutical Market, Pfizer, Global, Major Products, 2015 46
Table 11: Pharmaceutical Market, Pfizer, Global, Planned Filings, 2015 47
Table 12: Pharmaceutical Market, Sanofi, Global, Planned Filings, 2015 56
Table 13: Pharmaceutical Market, Bayer, Major Marketed Products, 2015 62
Table 14: Pharmaceutical Market, Bayer, Pipeline Products, 2015 66
Table 15: Medical Device Market, Turkey, Revenue ($bn), 2008-2015 74
Table 16: Medical Device Market, Turkey, Revenue ($bn), 2016-2020 75
Table 17: Medical Device Market, Turkey, Major Players by Revenue ($m) and Share (%), 2015 76
Table 18: Ophthalmic Device Market, Turkey, Revenue ($m), 2008-2015 77
Table 19: Ophthalmic Device Market, Turkey, Major Players by Revenue ($m) and Market Share (%), 2012 78
Table 20: Nephrology and Urology Diagnostics Device Market, Turkey, Revenue ($m), 2008-2015 79
Table 21: Nephrology and Urology Diagnostics Device Market, Turkey, Major Players by Revenue ($m) and Share (%), 2012 80
Table 22: Orthopedic Device Market, Turkey, Revenue ($m), 2008-2015 81
Table 23: Orthopedics Device Market, Turkey, Major Players by Revenue ($m) and Share (%), 2015 81
Table 24: Drug Delivery Device Market, Turkey, Revenue ($m), 2008-2015 82
Table 25: Drug Delivery Device Market, Turkey, Major Players by Revenue ($m) and Share (%), 2012 83
Table 26: Diabetes Care Device Market, Turkey, Revenue ($m), 2008-2015 84
Table 27: Diabetes Care Device Market, Turkey, Major Players by Revenue ($m) and Share (%), 2012 85
Table 28: Medical Device Market, Turkey, Revenue by Leading Companies ($m), 2012 86
Table 29: Baxter, Global, Major Products, 2016 87
Table 30: Major Products, Alcon, Major Products, 2015 96
Table 31: Fresenius Medical Care, Major Products, 2015 103
Table 32: Johnson and Johnson, Global, Major Products, 2016 110
Table 33: Healthcare Spending, Turkey, Patient Share (%), 2008-2015 133
Table 34: Healthcare Industry, Turkey, Price Change (%), 2008-2014 134
Table 35: Economic Indicators, Turkey, Gross Domestic Product per Capita ($), 2008-2015 160
Table 36: Economic Indicators, Turkey, Gross Domestic Product per Capita ($), 2016-2020 161
Table 37: Economic Indicators, Turkey, Gross Domestic Product Annual Growth (%), 2008-2015 162
Table 38: Economic Indicators, Turkey, Gross Domestic Product Annual Growth (%), 2016-2020 163
Table 39: Economic Indicators, Turkey, Gross National Income per Capita ($), 2008-2014 164
Table 40: Economic Indicators, Turkey, Consumer Price Index, 2008-2015 165
Table 41: Economic Indicators, Turkey, Consumer Price Index, 2016-2020 166
Table 42: Economic Indicators, Turkey, Average Annual Consumer Price Change (%), 2008-2015 167
Table 43: Economic Indicators, Turkey, Average Annual Consumer Price Change (%), 2016-2020 168
Table 44: Economic Indicators, Turkey, Currency Exchange Rate (TL/$), 2008-2015 169
Table 45: Economic Indicators, Turkey, Foreign Direct Investment ($bn), 2008-2014 170
Table 46: Economic Indicators, Turkey, Foreign Exchange Reserves ($bn), 2008-2014 171
Table 47: Economic Indicators, Turkey, Imports ($bn), 2008-2014 172
Table 48: Economic Indicators, Turkey, Exports ($bn), 2008-2014 173
Table 49: Economic Indicators, Turkey, Government Structural Balance ($bn), 2008-2015 174
Table 50: Economic Indicators, Turkey, Government Net Debt ($bn), 2008-2015 175
Table 51: Economic Indicators, Turkey, Government Net Debt ($bn), 2016-2020 176
Table 52: Economic Indicators, Turkey, Major Industries by Hours Worked Index, 2014 177
Table 53: Demographics, Turkey, Population (million), 2008-2015 178
Table 54: Demographics, Turkey, Population (million), 2016-2020 179
Table 55: Demographics, Turkey, Urban-Rural Population Share (%), 2008-2015 180
Table 56: Demographics, Turkey, Urban-Rural Population Share (%), 2016-2020 181
Table 57: Demographics, Turkey, Population Distribution by Age Group (%), 2008-2015 182
Table 58: Demographics, Turkey, Population Distribution by Age Group (%), 2016-2020 183
Table 59: Demographics, Turkey, Births (per 1,000 population), 2008-2015 184
Table 60: Demographics, Turkey, Mortality (per 1,000 population), 2008-2015 185
Table 61: Demographics, Turkey, Causes of Mortality (%), 2015 186
Table 62: Demographics, Turkey, Infant Mortality Rate (per 1,000 live births), 2008-2015 187
Table 63: Demographics, Turkey, Immunization Rate (%), 2008-2015 188
Table 64: Demographics, Turkey, Male Mortality Rate (%), 2014 189
Table 65: Demographics, Turkey, Female Mortality Rate (%), 2014 190
Table 66: Demographics, Turkey, Gender Ratio (M/F), 2008-2014 191
Table 67: Demographics, Turkey, Life Expectancy at Birth (years), 2008-2015 192
Table 68: Demographics, Turkey, Literacy by Age Group (%), 2014 194
Table 69: Demographics, Turkey, Unemployment Rate (%), 2008-2015 196
Table 70: Demographics, Turkey, Disability-Adjusted Life Years (per 1,000 population), 2009 197
Table 71: Healthcare Infrastructure, Turkey, Public and Private Hospitals, 2008-2015 198
Table 72: Healthcare Infrastructure, Turkey, Diagnostic Units (per 100,000 population), 2008-2015 199
Table 73: Healthcare Infrastructure, Turkey, Beds (per 1,000 population), 2008-2015 200
Table 74: Healthcare Parameters, Turkey, Beds by Type of Care (per 1,000 population), 2008-2015 201
Table 75: Healthcare Infrastructure, Turkey, Doctors (per 1,000 population), 2008-2015 202
Table 76: Demographics, Turkey, Water Pollution Sources (thousand m3/year), 2014 204
Table 77: Environmental Health, Turkey, CO2 Emissions (million tons), 2008-2015 205
Table 78: Environmental Health, Turkey, NOx Emissions (thousand tons), 2008-2015 206
Table 79: Environmental Health, Turkey, SOx Emissions (thousand tons), 2008-2015 207
Table 80: Environmental Health, Turkey, PM2.5 Emissions (µg/m3), 2008-2015 208
Table 81: Healthcare Personnel, Turkey, Nurses (per 100,000 population), 2008-2015 209
Table 82: Healthcare Personnel, Turkey, Pharmacists (per 100,000 population), 2008-2015 210
Table 83: Healthcare Personnel, Turkey, Dentists (per 100,000 population), 2008-2015 211
Table 84: Healthcare Expenditure, Turkey, Healthcare Expenditure (% of GDP), 2008-2015 212
Table 85: Healthcare Expenditure, Turkey, Share of Major Components (%), 2014 214
Table 86: Healthcare Expenditure, Turkey, Public-Private Share of Healthcare Expenditure ($ per capita), 2008-2015 215
Table 87: Healthcare Expenditure, Turkey, Public-Private Share of Healthcare Expenditure (% of GDP), 2008-2015 216
Table 88: Major Healthcare Trade Fairs, Turkey, 2016-2017 218

1.2 List of Figures
Figure 1: Pharmaceutical Market, Turkey, Revenue ($bn), 2008-2015 20
Figure 2: Pharmaceutical Market, Turkey, Revenue ($bn), 2016-2020 21
Figure 3: Pharmaceutical Market, Turkey, Imports and Exports ($bn), 2008-2015 23
Figure 4: Generic Market, Turkey, Revenue ($bn), 2008-2015 25
Figure 5: OTC Market, Turkey, Revenue ($bn), 2008-2015 26
Figure 6: Pharmaceutical Market, Turkey, Major Therapeutic Areas by Value (%), 2015 27
Figure 7: Medical Device Market, Turkey, Revenue ($bn), 2008-2015 74
Figure 8: Medical Device Market, Turkey, Revenue ($bn), 2016-2020 75
Figure 9: Medical Device Market, Turkey, Revenue by Segment ($m), 2015 76
Figure 10: Ophthalmic Device Market, Turkey, Revenue ($m), 2008-2015 77
Figure 11: Ophthalmic Device Market, Turkey, Major Players by Share (%), 2012 78
Figure 12: Nephrology and Urology Diagnostics Device Market, Turkey, Revenue ($m), 2008-2015 79
Figure 13: Nephrology and Urology Diagnostics Device Market, Turkey, Major Players by Share (%), 2012 79
Figure 14: Orthopedic Device Market, Turkey, Revenue ($m), 2008-2015 80
Figure 15: Orthopedics Device Market, Turkey, Major Players by Share (%), 2015 81
Figure 16: Drug Delivery Device Market, Turkey, Revenue ($m), 2008-2015 82
Figure 17: Drug Delivery Device Market, Turkey, Major Players by Share (%), 2012 83
Figure 18: Diabetes Care Device Market, Turkey, Revenue ($m), 2008-2015 84
Figure 19: Diabetes Care Device Market, Turkey, Major Players by Share (%), 2012 84
Figure 20: Medical Device Market, Turkey, Revenue by Leading Companies ($m), 2012 85
Figure 21: Healthcare Market, Turkey, Drivers and Barriers, 2016 122
Figure 22: Chronology of the Republican Era of Medicine and Pharmacy Management, Turkey, 2016 126
Figure 23: Strategic Planning Management, Turkey, 2016 127
Figure 24: Organizational Structure of Ministry of Health, Turkey, 2016 128
Figure 25: Drug Reimbursement Approval Process, Turkey, 2015 130
Figure 26: Healthcare Spending, Turkey, Patient Share (%), 2008-2015 133
Figure 27: Healthcare Industry, Turkey, Price Change (%), 2008-2014 134
Figure 28: Organizational Structure of Ministry of Health, Turkey, 2016 136
Figure 29: Major Health Reforms, Turkey, 2008-2015 157
Figure 30: Economic Indicators, Turkey, Gross Domestic Product per Capita ($), 2008-2015 160
Figure 31: Economic Indicators, Turkey, Gross Domestic Product per Capita ($), 2016-2020 161
Figure 32: Economic Indicators, Turkey, Gross Domestic Product Annual Growth (%), 2008-2015 162
Figure 33: Economic Indicators, Turkey, Gross Domestic Product Annual Growth (%), 2016-2020 163
Figure 34: Economic Indicators, Turkey, Gross National Income per Capita ($), 2008-2014 164
Figure 35: Economic Indicators, Turkey, Consumer Price Index, 2008-2015 165
Figure 36: Economic Indicators, Turkey, Consumer Price Index, 2016-2020 166
Figure 37: Economic Indicators, Turkey, Average Annual Consumer Price Change (%), 2008-2015 167
Figure 38: Economic Indicators, Turkey, Average Annual Consumer Price Change (%), 2016-2020 168
Figure 39: Economic Indicators, Turkey, Currency Exchange Rate (TL/$), 2008-2015 169
Figure 40: Economic Indicators, Turkey, Foreign Direct Investment ($bn), 2008-2014 170
Figure 41: Economic Indicators, Turkey, Foreign Exchange Reserves ($bn), 2008-2014 171
Figure 42: Economic Indicators, Turkey, Imports ($bn), 2008-2014 172
Figure 43: Economic Indicators, Turkey, Exports ($bn), 2008-2014 173
Figure 44: Economic Indicators, Turkey, Government Structural Balance ($bn), 2008-2015 174
Figure 45: Economic Indicators, Turkey, Government Net Debt ($bn), 2008-2015 175
Figure 46: Economic Indicators, Turkey, Government Net Debt ($bn), 2016-2020 176
Figure 47: Economic Indicators, Turkey, Major Industries by Hours Worked Index, 2014 177
Figure 48: Demographics, Turkey, Population (million), 2008-2015 178
Figure 49: Demographics, Turkey, Population (million), 2016-2020 179
Figure 50: Demographics, Turkey, Urban-Rural Population Share (%), 2008-2015 180
Figure 51: Demographics, Turkey, Urban-Rural Population Share (%), 2016-2020 181
Figure 52: Demographics, Turkey, Population Distribution by Age Group (%), 2008-2015 182
Figure 53: Demographics, Turkey, Population Distribution by Age Group (%), 2016-2020 183
Figure 54: Demographics, Turkey, Births (per 1,000 population), 2008-2015 184
Figure 55: Demographics, Turkey, Mortality (per 1,000 population), 2008-2015 185
Figure 56: Demographics, Turkey, Causes of Mortality (%), 2015 186
Figure 57: Demographics, Turkey, Infant Mortality Rate (per 1,000 live births), 2008-2015 187
Figure 58: Demographics, Turkey, Immunization Rate (%), 2008-2015 188
Figure 59: Demographics, Turkey, Male Mortality Rate (%), 2014 189
Figure 60: Demographics, Turkey, Female Mortality Rate (%), 2014 190
Figure 61: Demographics, Turkey, Gender Ratio (M/F), 2008-2015 191
Figure 62: Demographics, Turkey, Life Expectancy at Birth (years), 2008-2015 192
Figure 63: Demographics, Turkey, Literacy by Age Group (%), 2014 194
Figure 64: Demographics, Turkey, Unemployment Rate (%), 2008-2015 195
Figure 65: Demographics, Turkey, Disability-Adjusted Life Years (per 1,000 population), 2009 196
Figure 66: Healthcare Infrastructure, Turkey, Public and Private Hospitals, 2008-2015 198
Figure 67: Healthcare Infrastructure, Turkey, Diagnostic Units (per 100,000 population), 2008-2015 199
Figure 68: Healthcare Infrastructure, Turkey, Beds (per 1,000 population), 2008-2015 200
Figure 69: Healthcare Parameters, Turkey, Beds by Type of Care (per 1,000 population), 2008-2015 201
Figure 70: Healthcare Infrastructure, Turkey, Doctors (per 1,000 population), 2008-2015 202
Figure 71: Demographics, Turkey, Sources of Water Pollution (thousand m3/year), 2014 203
Figure 72: Environmental Health, Turkey, CO2 Emissions (million tons), 2008-2015 205
Figure 73: Environmental Health, Turkey, NOx Emissions (thousand tons), 2008-2015 206
Figure 74: Environmental Health, Turkey, SOx Emissions (thousand tons), 2008-2015 207
Figure 75: Environmental Health, Turkey, PM2.5 Emissions (µg/m3), 2008-2015 208
Figure 76: Healthcare Personnel, Turkey, Nurses (per 100,000 population), 2008-2015 209
Figure 77: Healthcare Personnel, Turkey, Pharmacists (per 100,000 population), 2008-2015 210
Figure 78: Healthcare Personnel, Turkey, Dentists (per 100,000 population), 2008-2015 211
Figure 79: Healthcare Expenditure, Turkey, Healthcare Expenditure (% of GDP), 2008-2015 212
Figure 80: Healthcare Expenditure, Turkey, Share of Major Components (%), 2014 213
Figure 81: Healthcare Expenditure, Turkey, Public-Private Share of Healthcare Expenditure ($ per capita), 2008-2015 215
Figure 82: Healthcare Expenditure, Turkey, Pharmaceutical RandD Expenditure (% of GDP), 2008-2015 216
Figure 83: Healthcare Market, Turkey, Opportunities and Challenges, 2016 222

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