Impact of Health Policy Changes on the Growth Locally Manufactured and Imported Pharmaceutical Markets In Turkey.

Abstract

PHP32 ImPact of HealtH PolIcy cHanges on tHe growtH locally manufactured and ImPorted PHarmaceutIcal markets In turkey Hilal Vural E.1, Kockaya G.2, Yenilmez F.B.3, Saylan M.2, Safak Yilmaz E.1, Tatar M.3, Vural I.M.1, Akbulat A.1, Gursoz H.1, Artiran G.1, Kerman S.1 1Turkish Medicines and Medical Devices Agency, Ankara, Turkey, 2Health Economics and Policy Association, Ankra, Turkey, 3Hacettepe University, Ankara, Turkey Objectives: Turkish Ministry of Health (MoH) initiated Health Transformation Program (HTP) in 2002. HTP impacted all clinical and economic outcomes of health including pharmaceutical sales by improving access to health services. The objective of this analysis is to to understand the impact of selected 5 major policy changes by MoH to sales of locally manufactured and imported pharmaceutical products in the respective periods. MethOds: 132 months sales data with segmented regression analysis for interrupted time series were used. International reference pricing of pharmaceuticals (RF), mandatory reimbursement dossier submission for new molecules, new indications and line extensions with medical and economic evaluations (MRDS), auditing for good manufacturing practice (GMP), family physician system (FP) and compulsory medical service for physicians (CMS) were selected as five major policies that may affect cost, demand and supply of pharmaceuticals. The analysis was conducted for total imported pharmaceutical (IP) sales and total locally manufactured pharmaceutical (LMP) sales. The Durbin-Watson d statistics of SPSS version 20.0 was used as serial correlation. Shift in slope with p< 0.05 was considered as statistically significant. Results: The negative effect of RF policy change on CS trends was more prominent for IP than LMP sales. However, the shift in CS due to other 4 policy changes was lower for IP when compared with LMP sales. The differences reached statistical significance level except for CMS policy. Although not significant, positive shift of US due to RF policy change was higher for LMP than IP sales. There was a decreasing slope of LMP unit sales following MRDS and GMP policies but an increasing slope of IP unit sales. cOnclusiOns: Policy changes may effect at differently direction and amount the unit and cost sales of LMPs and IPs. Cost control mechnism such as RF has a more negative effect on imported product as expected.