Journal of Literature Pharmacy Sciences

İlaç Fiyatlandırma Yöntemleri ve Dünyadan Türkiye'ye Bir Yansıma: Geleneksel Derleme
Pharmaceutical Pricing Methods and a Reflection from World to Türkiye: Traditional Review
Ebru ERDAĞa , Leyla YUMRUKAYAa , Selen YEĞENOĞLUa
aHacettepe Üniversitesi Eczacılık Fakültesi, Eczacılık İşletmeciliği ABD, Ankara, Türkiye
J Lit Pharm Sci. 2023;12(3):201-9
doi: 10.5336/pharmsci.2023-98571
Article Language: TR
Full Text
ÖZET
 Sağlık hizmetleri sunumuna ayrılan kaynakların, etkili ve verimli bir şekilde kullanılmasını araştıran sağlık ekonomisinin bir alt disiplini olan ilaç ekonomisi, ilaçlar için ayrılan kaynakların verimli kullanımını araştırmaktadır. Bu noktada, ilaçların fiyatlandırılmasında kullanılan yöntemler ve politikalar, sağlık hizmetleri sunumu için ayrılan kaynaklara doğrudan etki etmektedir. İlaç fiyatlandırılmasında dış referans fiyat, iç referans fiyat, değer-bazlı fiyatlandırma, kar marjı düzenlemeleri, fiyat müzakereleri, jenerik ve biyobenzer ilaçların kullanımının teşvik edilmesi, toplu alımlar, maliyete dayalı fiyatlandırma ve vergi düzenlemeleri gibi çeşitli yaklaşımlarla, ilaç maliyetlerinin kontrol altına alınması amaçlanmaktadır. Ülkeler; pazar durumu, demografik ve ekonomik özellikler gibi koşullarını göz önünde bulundurarak, bu yaklaşımlardan bir veya birkaçını bir arada uygulayabilmektedir. Türkiye'de ilaç fiyatlandırması, fiyat kararnameleri doğrultusunda gerçekleşmektedir. 1956 yılından başlamak üzere, birçok ilaç fiyat kararnamesi yayımlanmış, bu kararnameler tebliğler ile de destek desteklenmiştir. Zaman içerisinde birçok değişiklik olmuş, kar marjı düzenlemeleri ile başlayan uygulamalar günümüzde referans fiyatlandırma sistemi ve müzakere yaklaşımları ile devam etmektedir. Ancak her yaklaşım, avantajları ile birlikte dezavantajlar da getirmektedir. Bu bağlamda, referans fiyatlandırma yaklaşımı ile dünyadaki gelişmeler daha yakından takip edilmekte iken aynı zamanda referans ülkelerdeki ekonomik durum, kişi başı gelir düzeyi ve sağlık politikalarının farklı olması gibi nedenlerle kısıtlamalar ortaya çıkabilmektedir. Sağlık hizmetlerine ve ilaçlara erişim, sağlık hizmeti sunumunda kritik önem taşımaktadır. Bu kapsamda, bu çalışmada, ilaç fiyatlandırılmasında uygulanan çeşitli yöntemler, dünyadan örnekler ve ülkemizdeki uygulamalar bağlamında değerlendirilmiştir.

Anahtar Kelimeler: Farmakoekonomi; ilaç fiyatlandırma; ilaç fiyatlandırma yöntemleri; sağlık ekonomisi; sağlık harcamaları
ABSTRACT
 Pharmacoeconomics is a sub-discipline of health economics. And health economics focuses on the effective and efficient use of resources allocated for health services. Similarly, pharmacoeconomics focuses on the efficient use of resources allocated for pharmaceuticals. In this regard, the techniques and policies available for the pricing of pharmaceuticals directly affect the resources allocated for health services. Various approaches such as external reference pricing, internal reference pricing, value-based pricing, profit margin regulations, price negotiations, encouraging the use of generic and biosimilar medicines, pooled procurement, cost-plus pricing and tax regulations are used in order to control drug costs. Countries may apply one or a combination of these approaches, considering their conditions such as market position, demographic and economic characteristics. Drug pricing in Turkey is realised in line with price decrees. Starting from 1956, many drug price decrees were issued and these decrees were supported by communiqués. There have been many changes over time, and practices those started with profit margin regulations continue today with the reference pricing system and negotiation approaches. Yet, each approach brings disadvantages as well as advantages. In this context, while the reference pricing approach allows to follow-up global developments, it can also lead to limitations due to different economic conditions, income levels and health policies in the reference countries. Access to health services and pharmaceuticals has a critical importance in health service provision. Thus, in this study, various methods applied to pharmaceutical pricing are evaluated in the context of examples worldwide and practices in Türkiye.

Keywords: Pharmacoeconomics; pharmaceutical pricing; pharmaceutical pricing methods; health economics; health expenditure
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-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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