Health technology assessment in Türkiye: Current status and perspectives on future implementation

Abstract

Objective: Türkiye's health care system reforms have led not only to increased access to health care but also to rising pharmaceutical expenditures. Therefore, health technology assessment (HTA) has become an important tool for evaluating priorities in reimbursement and budget allocation. Our study aimed to describe the current HTA environment in Türkiye and explore long-term perspectives from a broad spectrum of Turkish stakeholders on the development of HTA in the next ten years. Methods: In 2019, we used a convenience sampling method to conduct an online survey with stakeholders from different areas in the health system. Additional face-to-face discussions were conducted to clarify answers when needed. We assessed the current evaluation process for pharmaceuticals and examined the need for HTA in Türkiye. Online survey data were extracted into Microsoft Excel for analysis. Quantitative data were summarised descriptively. Results: A total of 27 Turkish stakeholders completed the survey; 21 were employed in the public sector, and 6, in the private sector. The majority of participants (18/27) suggested introducing HTA for all new health technologies considered for public reimbursement and instituting an additional review process for currently reimbursed technologies. Most respondents (25/27) agreed that a threshold for cost-effectiveness should be applied in the next ten years. Conclusion: The stakeholders concurred that Türkiye must implement an HTA process soon. However, further discussion and interaction between stakeholders are essential to ensure a broad commitment to the implementation of a structured HTA process in Türkiye.