Türkiye’de İlaç Fiyatlandırma ve Geri Ödeme Politikalarının AB Ülkeleri ile Karşılaştırılması

Yıl 2018, Sayı: 108, 99 - 121, 01.03.2018

Seda Sönmez Gülnur İlgün

Öz

Sağlık hizmetlerinin insan hayatında vazgeçilemez olması ülkelerin sağlık ve sağlık hizmetleriyle ilgili konulara eğilimlerini artırmıştır. Toplumun sağlık ihtiyaçlarını karşılayacak sağlık hizmeti sunmanın yolu ise iyi planlanmış bir sağlık sistemi ve kaynak dağıtım politikasına bağlıdır. Ayrıca sağlık ihtiyaçlarının istenen düzeyde karşılanması, sürekli olarak artış eğilimi gösteren sağlık harcamaları ile baş edebilme gücüne bağlıdır. Ülkelerin hem sağlık ihtiyacını karşılamak hem de artan sağlık harcamaları ile baş edebilmek için harcamaları artıran faktörleri doğru bir şekilde belirleyip ilgili alanlara sürekli düzenlemeler yapması gerekmektedir. Bu noktada toplam sağlık harcamaları içinde ilaç harcamalarının payının yüksek olması ve gün geçtikçe daha da yükselmesi tüm ülkeleri ilaç harcamalarının etkin bir şekilde kontrol altına alınmasını sağlayacak fiyatlandırma ve geri ödeme süreçlerine ilişkin sürekli olarak düzenlemeler yapmaya zorlamaktadır. Buradan hareketle bu çalışmada Türkiye’deki ilaç fiyatlandırma ve geri ödeme politikalarının Avrupa Birliği AB ülkeleri ile karşılaştırılması amaçlanmıştır. Bu amaca yönelik olarak PHIS indikatörlerinden fiyatlandırma ve geri ödeme başlığında yer alan indikatörler kullanılarak karşılaştırmalar gerçekleştirilmiştir. Değerlendirme sonucunda fiyatlandırma politikalarından AB ülkelerinde en çok uluslararası referans fiyatlandırma yönteminin kullanıldığı ve ülkelerin çoğunun üretici fiyatını kontrol ettiği ve normalde uygulanmakta olan KDV oranından farklı oranlarda KDV aldıkları görülmüştür. Geri ödeme politikaları kapsamında ise ülkelerin çoğunlukla pozitif liste kullandığı ve geri ödeme kriterlerinde sağlık teknolojilerinin değerlendirilmesini dikkate aldıkları görülmüştür.

Anahtar Kelimeler

İlaç, Fiyatlandırma, Geri Ödeme, Türkiye, Avrupa Birliği Ülkeleri.

COMPARISON OF DRUG PRICING AND REIMBURSEMENT POLICIES IN TURKEY WITH EU COUNTRIES

Öz

The fact that health services are essential in human life has increased countries’ focus on matters related to health and health services. The way of delivering health care to meet the health needs of a community depends on a well-planned health care system and resource allocation policy. In addition, meeting the health needs at the desired level depends on the ability to cope with the health expenditures, which tend to increase continuously. In order to meet the health needs and cope with increasing health expenditure, the countries need to accurately identify the factors that increase spending, and make continuous adjustments on these factors. At this point, the high share of drug spending within the total health expenditure and the gradual increase of this share compel all countries to make regular adjustments to their pricing and reimbursement processes to ensure that drug spending is effectively controlled. From this point of view, the purpose of this study is to compare the drug pricing and reimbursement policies in Turkey with those in the European Union EU countries. For this purpose, we made comparisons with PHIS indicators by using the ones included in the pricing and reimbursement headings. As a result of the evaluation, we found that, as a pricing policy, the EU countries mostly use the international reference pricing method, and most countries check the producer price and get different VAT rates than the normal VAT rate. In the context of reimbursement policies, we observed that countries often use a positive list and take into account the assessment of health technology in reimbursement criteria.

Anahtar Kelimeler

Drug, Pricing, Reimbursement, Turkey, European Union Countries.

Kaynakça

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