ABSTRACT

The aim of this study was to determine the amount of out-of-pocket expenditure on medicines per year in Turkey and the proportion of this expense spend on domestically manufactured and imported medicines and that was covered under the Social Security System (SSS). In addition, by determining the variety of medicines used, the study aimed to investigate the type of medicines that dominates the out-of-pocket expenditure on medicines.

The data were obtained from the “Drug Tracking System (ITS)” database of the Turkish Pharmaceuticals and Medical Devices Agency. ITS is used for tracking and similar products. The data obtained from ITS were summarized and presented in tables. Calculations were performed using Microsoft Excel (Microsoft Office 365 ProPlus-tr), followed by ratio analysis.

According to our findings, 16.4%, 18.6%, and 19.2% of the total spending on medications, was paid out-of-pocket in the January 2015-December 2017. Regarding the number of boxes, 81.1% of the medicines paid out-of-pocket was domestically manufactured while 18.1% was imported between the same periods. In terms of monetary value in Turkish Lira, 59% of the medicines were domestically manufactured and 41% were imported. Of these medicines, 92.7% were covered by the repayment scheme of SSS, whereas 6.5% were not. The proportion of drugs covered by the repayment system based on monetary value was approximately 80%. According to the Anatomical and Therapeutic Chemical Classification System (ATC2) codes, antiinflammatory/ anti-rheumatic, analgesic/anti-pyretic, and cold/cough medicines were the top three groups in sales based on the number of boxes; this ranking changed to urological, hormonal/genital system, and anti-inflammatory/anti-rheumatic medicines based on the monetary value.

According to the results of this study, the bulk of medicines purchased through out-of-pocket payment between 2015 and 2017 would be reimbursed by SSS, and most of these medicines were manufactured domestically. In terms of medicines diversity, anti-inflammatory/ anti-rheumatic medicines were the highest in terms of cost, whereas urological medicines were the highest in terms of the number of boxes based on ATC2 codes.

Keywords: Out-of-pocket expenditure on medicines, drug tracking system, sales of medicines