Research Article
BibTex RIS Cite

TÜRKİYE’DE UYGULANAN İLAÇ POLİTİKALARI KONUSUNDA PAYDAŞLARIN GÖRÜŞ VE TERCİHLERİNİN ÇOK KRİTERLİ KARAR VERME YÖNTEMİ (ELECTRE III) İLE DEĞERLENDİRİLMESİ

Year 2021, Issue: 20, 565 - 591, 29.03.2022
https://doi.org/10.21441/sosyalguvence.1094352

Abstract

Yaşlanan nüfus ile birlikte hastalık yapısının değişmesi ve bunların yanı sıra sağlık bilincinin ve hizmetlere erişimin artması, sağlık politikalarının etkin bir şekilde seçilmesi ve kullanılması ihtiyacını artırmıştır. Söz konusu sağlık politikalarının önemli bir parçası da ilaç politikalarıdır. İlaç fiyatlandırma ve geri ödeme politikalarının bireylerin ihtiyaçlarını zamanında karşılayan, kaynakların etkin kullanımını sağlayan, araştırma geliştirme faaliyetlerini destekleyen bir yapıda olması beklenmektedir. Söz konusu beklentiler ilaç politikaları ile bağlantılı her bir paydaş grubuna göre farklılık gösterdiğinden, politikalarla ilgili tercihler de farklılaşmaktadır. Bu çalışma ile farklı paydaş gruplarının ilaç politikaları ile ilgili farklı görüş ve tercihlerinin ortaya konulması amaçlanmıştır. Bu amaçla akademisyenler, ilaç sektörü temsilcileri ve ruhsatlandırma, fiyatlandırma ve geri ödeme ile ilgili kamu kurumlarının temsilcilerinden oluşan paydaş gruplarında yer alan toplam 381 kişiye ilaç politikaları konusundaki tercihlerinin belirlenmesi amacıyla anket gönderilmiş, geri dönen 188 anketten verileri tam olan 179 anket Çok Kriterli Karar Verme yöntemlerinden ELECTRE III metodu yardımıyla analiz edilmiştir. Analiz sonucunda ilaç politikası paydaşlarının en fazla önem verdikleri politika amaçlarının ilaca erişim, sağlık sisteminin sürdürülebilirliği ile ilaç harcamalarının kontrolü ve kaynakların etkin tahsisi olduğu görülmüştür. Paydaşların sayılan amaçlara ulaşılmasında en etkili gördükleri araç ise hızlandırılmış ruhsatlandırma ve geri ödeme süreçleridir. Bunu sırasıyla farmakoekonomik değerlendirme ve alternatif geri ödeme sözleşmeleri takip etmiştir. Araştırma sonuçlarının karar vericilere mevcut politikaları değerlendirirken ve yeni politikalar oluştururken yol göstermesi beklenmektedir.

References

  • Almeida Dias, J., Figueira, J.R. & Roy, B. (2006). The Software Electre III-IV. Paris: University Paris-Dauphine Lamsade.
  • Belloni, A., Morgan, D. & Paris, V. (2016). Pharmaceutical expenditure and policies: past trends and future challenges (Rapor No: 87). Paris: OECD Publishing. https://www.oecd-ilibrary.org/social-issues-migration-health/pharmaceutical-expenditure-and policies_5jm0q1f4cdq7-en adresinden ulaşılmıştır.
  • Belton, V. & Steward, T.J. (2002). Multiple criteria decision analysis-an integrated approach. New York: Springer.
  • Buchanan, J., Sheppard, P & Vanderpooten, D. (1999). Project ranking using Electre III. Hamilton: University of Waikato.
  • Buente, M., Danner, S., Weissbacker, S. & Ramme, C. (2013). How emerging markets are driving the transformation of the pharmaceutical ındustry. PWC. https://www.pwc.ru/ru/pharmaceutical/publications/assets/Strategyand_Pharma-Emerging-Markets-2.0.pdf adresinden ulaşılmıştır.
  • Carone, G., Schwierz, C. & Xavier, A. (2012). Cost-containment policies in public pharmaceutical spending in the EU (Rapor No:461). Brussels: European Commission. https://ec.europa.eu/economy_finance/publications/economic_paper/2012/pdf/ecp_461_en.pdf adresinden ulaşılmıştır.
  • Cockburn, I.M. (2004). The changing structure of pharmaceutical industry. Health Affairs 23(1), 10-22. doi: 10.1377/hlthaff.23.1.10
  • Commision of The European Communities (2008). Safe, innovative and accessible medicines: a renewed vision for the pharmaceutical sector. Brussels: Commision of The European Communities. https://ec.europa.eu/growth/content/safe-innovative-and-accessible-medicines-renewed-vision-pharmaceutical-sector-0_fi adresinden ulaşılmıştır.
  • Cromwell, I., Peacock, S.J. & Mitton, J. (2015). Real-world health care priority setting using explicit decision criteria: a systematic review of the literature. BMC Health Services Research, 1-11. doi: 10.1186/s12913-015-0814-3
  • Çınar, Y. (2004). Çok nitelikli karar verme ve bankaların mali performanslarının değerlendirilmesi örneği (Yüksek lisans tezi). Ankara Üniversitesi Sosyal Bilimler Enstitüsü, Ankara.
  • Danzon, P.M. & Epstein, A.J. (2008). Effects of regulation on drug launch and pricing in interdependent markets (Rapor No:14041). Cambridge: National Bureau of Economic Research. https://ideas.repec.org/p/nbr/nberwo/14041.html adresinden ulaşılmıştır.
  • Del Vasto Terrientes, L.M. (2015). Hierarchical outranking methods for multi-criteria decision aiding (Doktora tezi). Universitat Rovira I Virgili, Tarragona.
  • Department for Communities and Local Government. (2009). Multi-criteria analysis-a manual. London: Department for Communities and Local Government. https://www.researchgate.net/publication/30529921_Multi-Criteria_Analysis_A_Manual/link/0c96051d57de66c14d000000/download adresinden ulaşılmıştır.
  • DSÖ (2001). How to develop and implement a national drug policy?. Geneva: WHO. http://apps.who.int/iris/bitstream/handle/10665/42423/924154547X.pdf;jsessionid=3B932F271E3FBBA0EBCAB3988906683E?sequence=1
  • Dukes, G. (2012). Toward sustainable access to medicines. M.Embrey (ed.). Managing access to medicines and health technologies. Management Sciences for Health.
  • European Commission (2014). Pharmaceutıcal industry: a strategic sector for the European economy (Rapor No: 216). Brussels: European Commission. http://ec.europa.eu/DocsRoom/documents/7649/attachments/1/translations adresinden ulaşılmıştır.
  • European Parliament (2011). Differences in costs of and access to pharmaceutical products in EU (Rapor No:12). Brussels: European Parliament. https://www.europarl.europa.eu/document/activities/cont/201201/20120130ATT36575/20120130ATT36575EN.pdf adresinden ulaşılmıştır.
  • Figueira, J., Greco, S., Roy, B. & Slowinski, R. (2010). Handbook of multicriteria analysis. Berlin: Springer. https://link.springer.com/chapter/10.1007/978-3-540-92828-7_3 adresinden ulaşılmıştır.
  • Hajkowitcz, S.A., McDonald, G.T. & Smith, P.N. (2000). An evaluation of multiple objective decision support weighting techniques in natural resource management. Journal of Enviromental Planning and Management, 43(4), 505-518. doi: 10.1080/713676575
  • Kanavos, P. & Angelis, A. (2013). Multiple criteria decision analysis for value based assessment of new medical technologies: a conceptual frame (Rapor No:33). London: LSE Health. https://www.researchgate.net/publication/266476731_Multiple_Criteria_Decision_Analysis_for_Value_Based_Assessment_of_New_Medical_Technologies_A_Conceptual_Framework adresinden ulaşılmıştır.
  • Kanavos, P. & Angelis, A. (2015). Using multiple criteria decision analysis (MCDA) to make coverage decisions: a methodological framework. Journal of Pharmaceutical Policy and Practice, 8 (1). doi: 10.1186/2052-3211-8-S1-O7 Keleş, M.K. & Tunca, M.Z. (2015). Hiyerarşik Electre yönteminin teknokent seçiminde kullanımı üzerine bir çalışma. Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 20(1), 199-223.
  • Kolasa, K., Zwolinski, K.M., Kalo, Z. & Hermanowski, T. (2016). Potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement process of orphan drugs. Orphanet Journal of Rare Diseases, 11-23. doi: 10.1186/s13023-016-0388-0
  • Majumder, M. (2015). Impact of urbanization on water shortage in face of climatic aberrations. Singapore: Springer Singapore. https://link.springer.com/book/10.1007/978-981-4560-73-3 adresinden ulaşılmıştır.
  • OECD (2015). Fiscal sustainability of health systems: bridging health and finance perspectives. Paris: OECD Publishings. https://www.oecd.org/gov/budgeting/Fiscal-Sustainability-of-Health-Systems-Policy-Brief-ENG.pdf adresinden ulaşılmıştır.
  • Paich, M., Peck, C. & Valant, J. (2011). Pharmaceutical market dynamics and strategic planning: a system dynamics perspective. System Dynamics Review, 27(1), 47-63. doi: 10.1002/sdr.458
  • Pena, R.R., Rebollo, R.P., Oliveras, K.G. & Mateu, A.V. (2007). Use and evaluation of Electre III/IV. Tarragona: Universitat Rovira i Virgili.
  • Rogers, M. & Bruen, M. (1998). Choosing realistic values of indifference, preference and veto thresholds for use with environmental criteria within Electre. European Journal of Operational Research, 107, 542-551. doi: 10.1016/S0377-2217(97)00175-6
  • Roy, B. (1968). The outranking approach and the foundations of Electre methods. Paris: Universite de Paris.
  • Schweitzer, S.O. (2007). Pharmaceutical economics and policy. New York: Oxford University Press
  • Seiter, A. (2010). A practical approach to pharmaceutical policy. Washington D.C.: The World Bank. https://www.researchgate.net/publication/260136814_A_Practical_Approach_to_Pharmaceutical_Policy adresinden ulaşılmıştır.
  • TİTCK. (t.y.). Erişim: 1 Mart 2018, http://www.titck.gov.tr/Kurumsal/GorevAlanlari
  • Vogler, S., Zimmermann, N. & Habl, C. (2013). Understanding the components of pharmaceutical expenditure-overview of pharmaceutical policies ınfluencing expenditure across european countries. Generics and Biosimilars Initiative Journal, 2(4), 178-187. doi: 10.5639/gabij.2013.0204.051
  • Vogler, S., Zimmermann, N. & Habimana, K. (2014). Study of the policy mix for the reimbursement of medicinal products-proposal for a best practice-based approach based on stakeholder assessment. Vienna: Health Programme of European Union. https://ec.europa.eu/health//sites/health/files/healthcare/docs/policymix_reimbursement_medicinal_products_en.pdf adresinden ulaşılmıştır.
  • Vogler, S., Zimmerman, N., Labry, A.O. & Espin, J (2015). Reimbursement measures in European countries-findings of a bibliometric literature review [Poster]. 3rd International PPRI Conference, Vienna.
  • Vogler, S., Zimmermann, N. & Habimana, K. (2016). Stakeholder preferences about policy objectives and measures of pharmaceutical pricing and reimbursement. Health Policy and Technology, 5, 213-225. doi: 10.1016/j.hlpt.2016.03.009
Year 2021, Issue: 20, 565 - 591, 29.03.2022
https://doi.org/10.21441/sosyalguvence.1094352

Abstract

References

  • Almeida Dias, J., Figueira, J.R. & Roy, B. (2006). The Software Electre III-IV. Paris: University Paris-Dauphine Lamsade.
  • Belloni, A., Morgan, D. & Paris, V. (2016). Pharmaceutical expenditure and policies: past trends and future challenges (Rapor No: 87). Paris: OECD Publishing. https://www.oecd-ilibrary.org/social-issues-migration-health/pharmaceutical-expenditure-and policies_5jm0q1f4cdq7-en adresinden ulaşılmıştır.
  • Belton, V. & Steward, T.J. (2002). Multiple criteria decision analysis-an integrated approach. New York: Springer.
  • Buchanan, J., Sheppard, P & Vanderpooten, D. (1999). Project ranking using Electre III. Hamilton: University of Waikato.
  • Buente, M., Danner, S., Weissbacker, S. & Ramme, C. (2013). How emerging markets are driving the transformation of the pharmaceutical ındustry. PWC. https://www.pwc.ru/ru/pharmaceutical/publications/assets/Strategyand_Pharma-Emerging-Markets-2.0.pdf adresinden ulaşılmıştır.
  • Carone, G., Schwierz, C. & Xavier, A. (2012). Cost-containment policies in public pharmaceutical spending in the EU (Rapor No:461). Brussels: European Commission. https://ec.europa.eu/economy_finance/publications/economic_paper/2012/pdf/ecp_461_en.pdf adresinden ulaşılmıştır.
  • Cockburn, I.M. (2004). The changing structure of pharmaceutical industry. Health Affairs 23(1), 10-22. doi: 10.1377/hlthaff.23.1.10
  • Commision of The European Communities (2008). Safe, innovative and accessible medicines: a renewed vision for the pharmaceutical sector. Brussels: Commision of The European Communities. https://ec.europa.eu/growth/content/safe-innovative-and-accessible-medicines-renewed-vision-pharmaceutical-sector-0_fi adresinden ulaşılmıştır.
  • Cromwell, I., Peacock, S.J. & Mitton, J. (2015). Real-world health care priority setting using explicit decision criteria: a systematic review of the literature. BMC Health Services Research, 1-11. doi: 10.1186/s12913-015-0814-3
  • Çınar, Y. (2004). Çok nitelikli karar verme ve bankaların mali performanslarının değerlendirilmesi örneği (Yüksek lisans tezi). Ankara Üniversitesi Sosyal Bilimler Enstitüsü, Ankara.
  • Danzon, P.M. & Epstein, A.J. (2008). Effects of regulation on drug launch and pricing in interdependent markets (Rapor No:14041). Cambridge: National Bureau of Economic Research. https://ideas.repec.org/p/nbr/nberwo/14041.html adresinden ulaşılmıştır.
  • Del Vasto Terrientes, L.M. (2015). Hierarchical outranking methods for multi-criteria decision aiding (Doktora tezi). Universitat Rovira I Virgili, Tarragona.
  • Department for Communities and Local Government. (2009). Multi-criteria analysis-a manual. London: Department for Communities and Local Government. https://www.researchgate.net/publication/30529921_Multi-Criteria_Analysis_A_Manual/link/0c96051d57de66c14d000000/download adresinden ulaşılmıştır.
  • DSÖ (2001). How to develop and implement a national drug policy?. Geneva: WHO. http://apps.who.int/iris/bitstream/handle/10665/42423/924154547X.pdf;jsessionid=3B932F271E3FBBA0EBCAB3988906683E?sequence=1
  • Dukes, G. (2012). Toward sustainable access to medicines. M.Embrey (ed.). Managing access to medicines and health technologies. Management Sciences for Health.
  • European Commission (2014). Pharmaceutıcal industry: a strategic sector for the European economy (Rapor No: 216). Brussels: European Commission. http://ec.europa.eu/DocsRoom/documents/7649/attachments/1/translations adresinden ulaşılmıştır.
  • European Parliament (2011). Differences in costs of and access to pharmaceutical products in EU (Rapor No:12). Brussels: European Parliament. https://www.europarl.europa.eu/document/activities/cont/201201/20120130ATT36575/20120130ATT36575EN.pdf adresinden ulaşılmıştır.
  • Figueira, J., Greco, S., Roy, B. & Slowinski, R. (2010). Handbook of multicriteria analysis. Berlin: Springer. https://link.springer.com/chapter/10.1007/978-3-540-92828-7_3 adresinden ulaşılmıştır.
  • Hajkowitcz, S.A., McDonald, G.T. & Smith, P.N. (2000). An evaluation of multiple objective decision support weighting techniques in natural resource management. Journal of Enviromental Planning and Management, 43(4), 505-518. doi: 10.1080/713676575
  • Kanavos, P. & Angelis, A. (2013). Multiple criteria decision analysis for value based assessment of new medical technologies: a conceptual frame (Rapor No:33). London: LSE Health. https://www.researchgate.net/publication/266476731_Multiple_Criteria_Decision_Analysis_for_Value_Based_Assessment_of_New_Medical_Technologies_A_Conceptual_Framework adresinden ulaşılmıştır.
  • Kanavos, P. & Angelis, A. (2015). Using multiple criteria decision analysis (MCDA) to make coverage decisions: a methodological framework. Journal of Pharmaceutical Policy and Practice, 8 (1). doi: 10.1186/2052-3211-8-S1-O7 Keleş, M.K. & Tunca, M.Z. (2015). Hiyerarşik Electre yönteminin teknokent seçiminde kullanımı üzerine bir çalışma. Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 20(1), 199-223.
  • Kolasa, K., Zwolinski, K.M., Kalo, Z. & Hermanowski, T. (2016). Potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement process of orphan drugs. Orphanet Journal of Rare Diseases, 11-23. doi: 10.1186/s13023-016-0388-0
  • Majumder, M. (2015). Impact of urbanization on water shortage in face of climatic aberrations. Singapore: Springer Singapore. https://link.springer.com/book/10.1007/978-981-4560-73-3 adresinden ulaşılmıştır.
  • OECD (2015). Fiscal sustainability of health systems: bridging health and finance perspectives. Paris: OECD Publishings. https://www.oecd.org/gov/budgeting/Fiscal-Sustainability-of-Health-Systems-Policy-Brief-ENG.pdf adresinden ulaşılmıştır.
  • Paich, M., Peck, C. & Valant, J. (2011). Pharmaceutical market dynamics and strategic planning: a system dynamics perspective. System Dynamics Review, 27(1), 47-63. doi: 10.1002/sdr.458
  • Pena, R.R., Rebollo, R.P., Oliveras, K.G. & Mateu, A.V. (2007). Use and evaluation of Electre III/IV. Tarragona: Universitat Rovira i Virgili.
  • Rogers, M. & Bruen, M. (1998). Choosing realistic values of indifference, preference and veto thresholds for use with environmental criteria within Electre. European Journal of Operational Research, 107, 542-551. doi: 10.1016/S0377-2217(97)00175-6
  • Roy, B. (1968). The outranking approach and the foundations of Electre methods. Paris: Universite de Paris.
  • Schweitzer, S.O. (2007). Pharmaceutical economics and policy. New York: Oxford University Press
  • Seiter, A. (2010). A practical approach to pharmaceutical policy. Washington D.C.: The World Bank. https://www.researchgate.net/publication/260136814_A_Practical_Approach_to_Pharmaceutical_Policy adresinden ulaşılmıştır.
  • TİTCK. (t.y.). Erişim: 1 Mart 2018, http://www.titck.gov.tr/Kurumsal/GorevAlanlari
  • Vogler, S., Zimmermann, N. & Habl, C. (2013). Understanding the components of pharmaceutical expenditure-overview of pharmaceutical policies ınfluencing expenditure across european countries. Generics and Biosimilars Initiative Journal, 2(4), 178-187. doi: 10.5639/gabij.2013.0204.051
  • Vogler, S., Zimmermann, N. & Habimana, K. (2014). Study of the policy mix for the reimbursement of medicinal products-proposal for a best practice-based approach based on stakeholder assessment. Vienna: Health Programme of European Union. https://ec.europa.eu/health//sites/health/files/healthcare/docs/policymix_reimbursement_medicinal_products_en.pdf adresinden ulaşılmıştır.
  • Vogler, S., Zimmerman, N., Labry, A.O. & Espin, J (2015). Reimbursement measures in European countries-findings of a bibliometric literature review [Poster]. 3rd International PPRI Conference, Vienna.
  • Vogler, S., Zimmermann, N. & Habimana, K. (2016). Stakeholder preferences about policy objectives and measures of pharmaceutical pricing and reimbursement. Health Policy and Technology, 5, 213-225. doi: 10.1016/j.hlpt.2016.03.009
There are 35 citations in total.

Details

Primary Language Turkish
Subjects Health Policy
Journal Section Makaleler
Authors

Canan Demir This is me 0000-0001-6039-7263

Bayram Şahin This is me 0000-0003-2772-3033

Publication Date March 29, 2022
Published in Issue Year 2021 Issue: 20

Cite

APA Demir, C., & Şahin, B. (2022). TÜRKİYE’DE UYGULANAN İLAÇ POLİTİKALARI KONUSUNDA PAYDAŞLARIN GÖRÜŞ VE TERCİHLERİNİN ÇOK KRİTERLİ KARAR VERME YÖNTEMİ (ELECTRE III) İLE DEĞERLENDİRİLMESİ. Sosyal Güvence(20), 565-591. https://doi.org/10.21441/sosyalguvence.1094352