Turkey Wants Drug Purchasing Power Translated Into New Biotech Investments

In response to drug shortages, Turkey should use its muscle as a major buyer and importer of pharmaceuticals to increase biotech investment and build up the local industry to ensure supplies, said Minister of Science, Industry and Technology Nihat Ergün.

ISTANBUL – Turkey’s main drug reimbursement agency, SGK, needs to translate its purchasing power into a broader national goal of seeking international biotechnology investments to build up local industry as the country seeks to balance ambitious plans for health care against rising costs and sometimes problematic access to drugs, particularly in oncology.

Efforts to foster a homegrown drug industry include three biomedical projects at leading Turkish universities aimed at basic drug discovery and spurring innovation as well as building a biomedical hub for treatment. But Nihat Ergun, minister for Science, Industry and Technology said more effort needs to be done to bring in investments (Also see "Turkey Pushes R&D Drug Discovery As Health Minister Gets Set To Meet Top U.S. Officials" - Scrip, 12 Apr, 2013.).

"Medical biotechnology is an important part of the health sector and we are going to determine the steps to be taken within public and private sectors, as well as universities,” Ergun said during the Medical Biotechnology Conference, organized by the Scientific and Technologic Research Institute of Turkey (TUBİTAK) in Ankara on May 27.

“We import more than $7 billion worth of biotechnology products, with very limited amount of exports. It is a very important field for us,” he said

TUBITAK's Biotechnology Research Center has started to develop gene maps, he said, and in one study it established links between genes and at least three different diseases.

"We initiated significant incentives for investments in the pharmaceutical sector, as well as medical devices," said Ergun. "So far we have used SGK's tremendous purchasing power to push drug prices down. From now on it should be used to attract investments, particularly innovative biotechnology investments. Turkey has the power and potential in this field."

Access to oncology drugs has been an issue in the country after a young student in early May confronted a minister saying she was unable to access dacarbazine to treat her lymphoma. As a result of the public attention, the drug was procured by the Turkish Union of Pharmacists and sent to the University of Thrace Medicine Faculty Hospital where the student is now being treated (Also see "Turkey To Produce Cancer Drugs Locally, But Looks To Big Pharma To Invest In Infrastructure" - Scrip, 8 May, 2013.).

The government said it has a plan underway to alleviate a shortage of at least six oncology drugs – deticene, dacarbazine, flutamin, daunomycin, mercaptopurine, tioguanine and cytarabine – by getting local producers to make generics available. But the issue flared anew in late May after a correspondent for the newspaper, Radikal, posed as the relative of a cancer patient seeking black market oncology drugs that sold for as much as 17 times the official price.

Trade Deficit For Turkish Pharma Industry

Ergun's words reflected a similar approach by SGK President Yadigâr Gökalp Ilhan, who announced in May that the agency has been working on an incentive package, which includes eliminating or reducing the required discount rate on investor products.

"Turkey produces 3,100 different drugs, but when we look at the pharmaceutical sector foreign trade figures; we see that exports are only around 16% of imports,” he said

“We have to take steps in the pharmaceutical sector to increase R&D and added value. In order to do this we have prepared the Pharmaceutical Strategy Document Action Plan [See: Vision 2023 Report]. We have determined 53 actions for six different targets. We will be implementing this plan as soon as possible."

Turkish Minister of Health Mehmet Muezzinoglu encouraged leading international biopharmaceutical firms to invest in Turkey during a session at the 2013 BIO International Conference April 23 in Chicago. He said that Turkey has the 16th biggest market in the world and the sixth-largest in Europe.

"In comparison with these scales, our share from the world's pharmaceutical exports and biotechnological discoveries is very low. We want to change this situation and rise in the league of global biotechnology," he said (Also see "Turkey’s New Health Minister Sees Free Health Care Zones Hosting Two Million Patients In Next Decade" - Scrip, 8 Mar, 2013.).

Turkish health care spending is increasing significantly, he said, pointing to increased investments in public hospitals, called the Public Hospitals Transformation. “There would be significant benefits for brave investors who invest in Turkey," he said.

According to IMS Health data, the total drug market in Turkey decreased by about 5% in 2012 due to price cuts. IMS projects about 3-4% annual market growth during 2013-2015.

Industry Tries To Set The Tone

During the 11th General Assembly of the Association Research Based Pharmaceutical Companies (AIFD), which took place on May 29, Güldem Berkman, president of the board, emphasized that after a difficult three-year period, things will be a bit brighter in the 2012-2015 period, as the government envisages an annual growth of almost 8% this year for the pharmaceutical sector (Also see "Turkey And Industry Tussle On Policy Following Price Cuts" - Scrip, 4 Feb, 2013.).

AIFD’s vision, expressed in the report, titled "Turkish Pharmaceutical Sector: Vision 2023", found its way into some important government documents, according to industry executives who spoke to PharmAsia News, signaling the government has paid close attention (Also see "Turkey Draws Roadmap To Become A Key Pharmaceutical Exporter In The Next Decade" - Scrip, 27 Sep, 2012.).

Industrial sources also pointed out that the draft text of a new patent law, which at one point seemed like it was going to be problematic for the innovative industry, has also been changed closer to international standards, and is expected to be passed by Parliament (Also see "Innovative Drug Firms Want More Sting As Turkey Moves To End Patent Penalty Limbo" - Scrip, 27 Mar, 2013.).

Cancer Drugs On The Black Market

But the cancer drug story in Radikal highlighted the difficulty in ramping up production quickly enough to meet surging demand following a decade of reimbursement expansion.

The reporter tried to find three drugs: Bristol-Myers Squibb Co.’s Blenoxane (bleomycin), Sanofi’s Deticene (dacarbazine) and Aspen Pharmacare Holdings Ltd.’s Purinethol (mercaptopurine), formerly made by GlaxoSmithKline PLC

Failing to get them at pharmacies, the reporter was contacted by black marketers, who demanded TL 120 ($64.50) for Purinethol (official price TL 9) and TL 900 ($484) for Deticene (official price TL 52).

Industry blames the access problem on the government's pricing policies, pointing out that drugs priced too low discourage companies from importing their products (Also see "Turkey’s Drug Bill Dips In 2012; Industry Blames Unsustainable Pressure, Government Cites Efficiencies" - Scrip, 20 May, 2013.).

Harun Kızılay, the secretary general of the Turkish Pharmacists' Association (TEB) – the organization authorized to import drugs for individual patients – concurred that the pricing policy remains the culprit.

"The pricing policy is wrong and it causes serious problems in accessing some products. … The fact that some drugs cannot be found in pharmacies caused the black market. However, if they apply to us we do supply these drugs," Kızılay said.

It is estimated that thousands of people apply to TEB every month for the drugs they can’t find in pharmacies. However it takes between two to 30 days for TEB to provide drugs.

The Head of SGK’s Pharmaceutical Department Hüseyin Kilicaslan said the current shortage of oncology drugs will be eased this month.

“As procuring these missing drugs from abroad is problematic, we started work to manufacture them in Turkey, he said in a May 28 press statement.

“We produced a generic of bleomycin, called Blemisin. It is being distributed at the moment. In coming days patients will be able to find this product in pharmacies. We made an agreement with the manufacturing firm Purinethol for importing significant amounts of this product. It will be on the market by June 3. We also produced deticene. It is being tested. We are planning to present it to the market in June."