Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-25T00:18:21.463Z Has data issue: false hasContentIssue false
  • English
  • Français

HEALTH TECHNOLOGY ASSESSMENT IN TURKEY*

Published online by Cambridge University Press:  09 June 2017

Rabia Kahveci ,
Esra Meltem Koç  and
Emine Özer Küçük
Rabia Kahveci
Affiliation:
Ankara Numune Training and Research Hospitaldrrabiakahveci@yahoo.com
Esra Meltem Koç
Affiliation:
Ministry of Health, General Directorate of Health Research
Emine Özer Küçük
Affiliation:
Ankara Numune Training and Research Hospital
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The healthcare transformation program in Turkey has shown its success with improvements in important health indicators, increased access to healthcare services and expansion of coverage to all citizens. Turkey has been relatively able to bear the burdens associated with this due to rapid economic growth. The need for health technology assessment (HTA) was believed as a result of the expansion of coverage, pressure of new technologies, and increased expenditures. This study outlines the background and current formalization of HTA and shares the current use of HTA in decision making, while summarizing the transformation of the Turkish healthcare system for developing a high-quality, equal, and accessible care system.

Methods: We reviewed and analyzed policy changes in the Turkish healthcare system, universal health coverage, healthcare expenditures, and pricing and reimbursement policies to identify the changes leading to HTA. We reviewed existing HTA functions in Turkey and outlined their activities. Finally, we outlined a set of major challenges for HTA in Turkey over the next decade.

Results: HTA was formalized in Turkey in 2012–2013 with three national HTA structures and one hospital-based HTA unit. These functions currently run independent from each other. There are three major challenges in this country for HTA in the next decade: clarification of the assessment scope and methods, building a strong supporting system for HTA, and defining the role of HTA in the future vision of Turkish healthcare policy.

Conclusion: HTA, despite challenges, has a good opportunity to develop further with clear action plans and strong political will.

Keywords

Health technology assessmentTurkeyHealth policyEvidence-based medicine
Type
Theme Submissions
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 3: Theme: HTA in Central-Eastern-Southern Europe , 2017 , pp. 402 - 408
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: https://www.textcheck.com/certificate/TFAUwS. We thank Oya Demir and Ayşen Şentürk who provided information on legislations and highly contributed to the article.

References

REFERENCES

1. Atun, R, Aydın, S, Chakraborty, S, et al. Universal health coverage in Turkey: Enhancement of equity. Lancet. 2013:382:65-99.Google Scholar
2. Oortwijn, W, Mathijssen, J, Banta, D. The role of health technology assessment on pharmaceutical reimbursement in selected middle-income countries. Health Policy. 2010;95:174-184.CrossRefGoogle ScholarPubMed
3. Turkey moves to adopt Health Technology Assessment. HTA Uncovered. 2014;6:4-7.Google Scholar
4. Kahveci, R, Meads, CA. Analysis of strengths, weaknesses, opportunities and threats in the development of a health technology assessment program in Turkey. Int J Technol Assess Health Care. 2008;24:235- 240.CrossRefGoogle ScholarPubMed
5. Kahveci, R. International Meeting for HTA-Emerging Countries. Int J Technol Assess Health Care. 2009;25:425-426.Google Scholar
6. Kahveci, R, ed. Hastane Tabanlı Sağlık Teknolojileri Değerlendirme (Hospital Based Health Technology Assessment). 1st ed. Ankara: Sage Yayıncılık; 2015. Turkish.Google Scholar
7. Kahveci R. Sağlık Teknolojilerinin Değerlendirilmesi: Dünyada Gelişmeler ve Türkiye'ye Yansımalar (Health Technology Assessment: Developments in the world and reflections for Turkey). Çerçeve Dergisi. 2011;19:110-119. Turkish.Google Scholar
8. Kahveci, R. Sağlık Teknolojilerinin Değerlendirilmesi: Araştırmalara Yansımalar (Health Technology Assessment: Reflections to Research). Sağlık Düşüncesi ve Tıp Kültürü Dergisi. 2012:10-11. Turkish.Google Scholar
9. Tatar, M, Wertheimer, AI. Sağlık Teknolojilerinin Değerlendirilmesi İlaç Geri Ödeme Kararları İçin Bir Model Önerisi (HTA A suggested model for pharmaceutical reimbursement). 1st ed. Ankara: MN Medikal&Nobel Basım Yayın; 2010. Turkish.Google Scholar
10. Tatar, M, Mollahaliloglu, S, Sahin, B, Aydin, S, Marisse, A. Hernández-Quevedo C. Turkey: Health system review. Health Syst Transit. 2011:13;1-186.Google ScholarPubMed
11. Turkey Health Transformation Program Assessment Report (2003-2011). https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/SDPing.pdf (accessed August 10, 2015)/Google Scholar
12. Erol, H, Ozdemir, A. Health reforms and the evaluation of health expenditures in Turkey. J Soc Secur. 2014;1:9-34.Google Scholar
13. Salomon, JA, Haidong, W, Freeman, MK, et al. Healthy life expectancy for 187 countries, 1990-2010: A systematic analysis for the Global Burden Disease Study 2010. Lancet. 2012;380:2144-2166. Erratum in: Lancet. 2013;381:628.Google Scholar
14. The Ministry of Health of Turkey Health Statistics Yearbook 2014. https://ekutuphane.sagem.gov.tr/kitaplar/health_statistics_yearbook_2014.pdf (accessed January 15, 2016).Google Scholar
15. WHO. WHO vaccine-preventable diseases: Monitoring system 2015 global summary. Turkey. https://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=TUR (accessed January 15, 2016).Google Scholar
16. UNICEF/WHO/World Bank/United Nations. Levels and trends in child mortality. Report 2012. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. https://www.childmortality.org/files_v20/download/Levels%20and%20Trends%20in%20Child%20Mortality%20Report%202012.pdf (accessed January 16, 2016).Google Scholar
17. World Health Organization. Global Health Observatory Data Repository. MDG 4: Child mortality: Infant mortality by country. https://apps.who.int/gho/data/node.main.526 (accessed January 16, 2016).Google Scholar
18. The World Bank (Internet) https://data.worldbank.org/country/turkey/turkish#cp_wdi (accessed January 16, 2016).Google Scholar
19. The World Bank.(Internet) Health expenditure, total (%GDP). https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS (accessed January 23, 2016).Google Scholar
20. Decree for Pricing of Medicinal Products for Human Use, Official Gazette, Number: 25373, (February 14, 2004).Google Scholar
21. Directive on the Operating Procedures and Principles of the Reimbursement Committee Socal Security Institution (2007). Published on 01.08.2007.Google Scholar
22. Socal Security Institution (2012). Directive on the Operating Procedures and Priciples of the Reimbursement of Medical Supplies Committee. https://www.sgk.gov.tr/wps/portal/tr/mevzuat/yururlukteki_mevzuat/yönergeler (accessed January 18, 2016).Google Scholar
23. Republic of Turkey Ministry of Development The Tenth Development Plan (2014-2018), Ankara, 2013. https://www.mod.gov.tr/Pages/DevelopmentPlans.aspx (accessed January 18, 2016).Google Scholar
24. Kahveci, R, Tütüncü, T, Yüksek, YN, Özer Küçük, E, Koç, EM, Zengin, N. Hospital based HTA in Turkey. In: Sampietro-Colom, L, Martin, J, eds. Hospital-based health technology assessment: The next frontier for HTA. Berlin: Springer-Verlag (2016). ISBN: 978-3-319-39203-5 (Print) 978-3-319-39205-9 (Online) pp. 95-105.CrossRefGoogle Scholar
25. The legislative decree number 663 about the Organization and Functions of the Ministry of Health and its Affiliates, Official Gazette, Number: 28103 (Repeat), (November 2, 2011).Google Scholar
26. The General Directorate of Health Research Health Technology Assessment Policy Statement. https://www.hta.gov.tr/politika.aspx (accessed August 20, 2015).Google Scholar
27. The General Directorate of Health Research Health Technology Assessment Directive. https://www.hta.gov.tr/pdf/STD_HTA_Yonerge.pdf (accessed January 18, 2016).Google Scholar
28. EUnetHTA European network for Health Technology Assessment. https://www.eunethta.eu (accessed September 25, 2016).Google Scholar
29. The analysis of the effects of public interventions of the first 100 drugs by value during the period between 2008-2013”. https://www.titck.gov.tr/PortalAdmin/Uploads/Titck/Big/Kamu%20Mudahalelerinin%202008-2013%20Donemindeki%20Deger%20Bazinda%20STD%20Raporu1%20.pdf (accessed January 18, 2016).Google Scholar
30. Sampietro-Colom, L, Lach, K, Escolar, I, et al. A handbook and a toolkit for hospital-based health technology assessment. Value Health. 2015;18:A556.Google Scholar
31. Kidholm, K, Ølholm, AM, Birk-Olsen, M, et al. Hospital managers' need for information in decision-making - An interview study in nine European countries. Health Policy. 2015;119:1424-1432.Google Scholar
32. Turkish Institute of Management Sciences. https://tusside.tubitak.gov.tr/en/About-us/General-Information (accessed January 2016).Google Scholar
33. Eurasian Health Technology Assessment. https://www.eurasianhta.org (accessed September 24, 2016).Google Scholar