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RATIONAL DRUG USE POLICY
IN TURKEY
Dedeoglu, Burcak Deniz; Celik, Hatice Demet; Akbulat, Akif; Akar,
Halil; Kerman, Saim.
Abstract
RATIONAL DRUG USE POLICY IN TURKEY
Burcak Deniz Dedeoglu, Hatice Demet Celik, Akif Akbulat, Halil Akar, Saim Kerman
Ministry of Health of Turkey, Turkey
Studies were conducted by Ministry of Health and many different associations on the issue about
“Rational drug use” in Turkey. Institutional activities regarding this issue has been initiated on
12.10.2010 by the Ministry of Health of TURKEY with the establishment of rational drug use department
under the the department of pharmacoeconomics.
Among the main purposes of the Rational Drug Use Department; generalizing the principles of rational
drug use all over the TURKEY and performing campaigns with this aim can be stressed. In order to make
suggestions to Social Security Institution (SSI) about the issues of; considering the principles of rational
drug use while devoloping the repayment (reimbursement) plans, obtaining the education of the health
staff on principles of rational drug use, evaluating the prescriptions according to principles of rational
drug use, coordinating the publishment of the national guidelines for diagnosis and treatment and drug
guideline periodically and measuring the awareness level of society and health staff about rational drug
use.
Based on the data taken from SSI, excluding the primary healthcare services, the number of patients
applied to a healthcare service and invoices have been sent to SSI in 2008, 2009 and 2010 were
216.930.000, 247.142.000 and 230.112.000 (for first ten months of 2010) respectively, in Turkey. These
numbers were classified as “outpatients”, “inpatients”, “others” and “daily” for months. In monthly
distrubition perspective, the applications were higher in summer than winter.
Total prescription number for workers, civil servants and green card owners in 2009 and 2010 (for first
ten months of 2010) were 327.000.000 and 250.138.000 respectively and total prescription invoice
number was 16.000 billion TL and 12.259 billion TL. while the average costs per prescription were 48.95
TL. and 49.01 TL, respectively.
The expectation is, the rational drug use policy will reduce the total drug cost and increase the
awareness of society and health staff about rational drug use.
Introduction
Studies were conducted by Ministry of Health and many different
associations on the issue about “Rational drug use” in Turkey.
Institutional activities regarding this issue has been initiated on
12.10.2010 by the Ministry of Health of Turkey with the establishment of
rational drug use department.
Among the main purposes of the Rational Drug Use Department;
generalizing the principles of rational drug use all over the Turkey and
performing campaigns with this aim can be stressed.
In order to make suggestions to Social Security Institution (SSI) about the
issues of; considering the principles of rational drug use while
devoloping the repayment (reimbursement) plans, obtaining the
education of the health staff on principles of rational drug use,
evaluating the prescriptions according to principles of rational drug use,
coordinating the publishment of the national guidelines for diagnosis
and treatment and drug guideline periodically and measuring the
awareness level of society and health staff about rational drug use.
Objectives
Evaluation the current situation about healthcare services and drugs by
analaysing the data of SSI and IMS Institute for Healthcare Informatics.
The number of patients applied to a healthcare services and invoice
costs; the number of prescription taken from Pharmacy Prevision System
and invoice costs; 2010 drug units and costs according to ATC (Anatomical
Therapeutic Chemical) codes were analaysed.
Results 1
Application
Invoice
Number (x1000) Cost (x1000 TL)
Mean Cost
IC/AN (TL)
2008
210.930
13.771.434
63.48
2009
247.142
15.653.143
63.34
2010
277.634
18.488.386
66.59
2011
(first 5 months)
134.969
9.118.785
67.56
Table 1: The number of patients applied to a healthcare service,
excluding the primary healthcare services, and invoice costs
Ref: SSI Monthly Statistical Bulletin; Publication No:13
P.S.: Data are expanded than the abstract because of the new version of
SSI Statistical Bulletin
Results 2
Prescription
Invoice
Mean Cost
Number (x1000) Cost (x1000 TL) IC/PN (TL)
2008
302.412
13.046.556
43.14
2009
327.001
16.005.392
48.95
2010
306.461
14.897.455
48.61
2011
(first 5 months)
148.561
6.537.442
44.01
Table 2: The number of prescription taken from Pharmacy Provision
System and invoice costs
Ref: SSI Monthly Statistical Bulletin; Publication No:13
P.S.: Data are expanded than the abstract because of the new version
of SSI Statistical Bulletin
Results 3
Units Year/10 (Absolute)
A0 ALIMENTARY T.& METABOLISM
R0 RESPIRATORY SYSTEM
J0 SYSTEMIC ANTI-INFECTIVES
M0 MUSCULO-SKELETAL SYSTEM
N0 NERVOUS SYSTEM
226.479.339
225.593.377
223.775.601
215.060.221
190.285.791
C0 CARDIOVASCULAR SYSTEM
D0 DERMATOLOGICALS
B0 BLOOD + B.FORMING ORGANS
G0 G.U.SYSTEM & SEX HORMONES
S0 SENSORY ORGANS
V0 VARIOUS
H0 SYSTEMIC HORMONES
T0 DIAGNOSTIC AGENTS
K0 HOSPITAL SOLUTIONS
L0 ANTINEOPLAST+IMMUNOMODUL
P0 PARASITOLOGY
153.493.692
85.449.907
62.125.768
54.282.589
45.532.429
38.377.213
23.332.437
8.162.516
7.818.533
5.242.349
5.040.567
Table 3: Drug Units in 2010 acording to ATC code
Ref: IMS Institute for Healthcare Informatics
Results 4
J0 SYSTEMIC ANTI-INFECTIVES
A0 ALIMENTARY T.& METABOLISM
C0 CARDIOVASCULAR SYSTEM
R0 RESPIRATORY SYSTEM
N0 NERVOUS SYSTEM
L0 ANTINEOPLAST+IMMUNOMODUL
M0 MUSCULO-SKELETAL SYSTEM
G0 G.U.SYSTEM & SEX HORMONES
B0 BLOOD + B.FORMING ORGANS
D0 DERMATOLOGICALS
V0 VARIOUS
S0 SENSORY ORGANS
T0 DIAGNOSTIC AGENTS
H0 SYSTEMIC HORMONES
K0 HOSPITAL SOLUTIONS
P0 PARASITOLOGY
TL Year/10 (Absolute)
2.215.529.632
2.112.972.993
1.817.350.371
1.670.760.391
1.613.233.082
1.260.034.408
1.142.104.150
713.159.010
631.879.716
510.403.595
333.849.317
302.511.660
230.520.845
194.499.452
29.833.434
15.592.092
Table 4: Drug costs in 2010 acording to ATC code
Ref: IMS Institute for Healthcare Informatics
Policy Implications & Conclutions
Among the main purposes of the Rational Drug Use Department;
generalizing the principles of rational drug use all over the Turkey and
performing campaigns with this aim can be stressed. In order to make
suggestions to Social Security Institution (SSI) about the issues of;
considering the principles of rational drug use while devoloping the
repayment (reimbursement) plans, obtaining the education of the health
staff on principles of rational drug use, evaluating the prescriptions
according to principles of rational drug use, coordinating the publishment
of the national guidelines for diagnosis and treatment and drug guideline
periodically and measuring the awareness level of society and health staff
about rational drug use.
The expectation is, the rational drug use policy will reduce the total drug
cost and increase the awareness of society and health staff about rational
drug use.