Pricing and reimbursement of generic pharmaceuticals in Turkey: Evaluation of hypertension drugs from 2007 to 2013

Abstract

Purpose: This study was designed to examine the effects of drug pricing and reimbursement politics on drug expenditures from January 2007 to September 2013, with a focus on internal reference pricing in Turkey. Method: Data used in this study are from January 2007 to September 2013, which includes five drug clusters involving original drugs and the first generic drug (equivalent of the original drug) that was available on the market in 2010 and 2011. The effect of the first generic drug that entered the market on original drug use was analyzed using the time-series analysis method. To account for the absence of generic drugs in the market, original drug consumption was estimated and compared with original drug consumption following generic drug entry. Winters' Additive was selected as the most suitable method to estimate the consumption amount of the original drug in the five equivalent groups. Results: From 2007 to 2012, the consumption of prescribed drugs in the hypertension group increased about 63% and hypertension drug expenditures of the Social Security Institute (SSI) increased almost 82%. Between 2007 and 2012, the increase in hypertension drug consumption not included in the equivalent group was 83%, whereas it was calculated as 61% for drugs in the equivalent group. The prices of the original and generic drugs were similar as time went by and after regulation by authorities. Conclusion: The generic drug market in Turkey has not reached its full potential. Original pharmaceuticals still dominate most of the market. The internal reference pricing system in Turkey has not been able to encourage price competitiveness and price reductions.