Healthcare Resource Guide: Turkey

 

Turkey

Statistics

Summary Market Entry
Current Market Trends

Main Competitors

Current Demand

Barriers

Registration Process
Trade Events

Government Links

CS Contact

FAQ

Capital: Ankara

Population: 81,619,392 GDP*: USD 10,900

Currency: Turkish Lira (TL)

Language: Turkish

Summary

Turkey has a population of 81 million people and is a growing market for medical technologies and healthcare services. The Ministry of Health (MOH) is the largest provider of healthcare and the only public provider of preventive services in Turkey. Turkish medical equipment market is approximately $3 billion and has been growing at the rate of 5-10% every year since 2002. 90% of the products used are imported; however, there is strong push by Turkish Government to strengthen and grow local manufacturing. In the coming years, percentage of imported products in the market may go down; however, Turkey and region will continue to be an attractive market for advanced and innovative American products.

Market Entry

U.S. medical equipment manufacturers can either open their own offices in Turkey and equip it with their own sales and marketing force or appoint national and, most of the time, exclusive distributors in Turkey. The distributor/importer should have strong reseller base to market and service the products all around the country, follow the tenders and also be knowledgeable about importing medical devices into Turkey.

Current Market Trends

Turkey has a 2-level approach to the delivery of public healthcare services. First-level treatment is delivered by family practitioners who are appointed to population groups of 3,000 people living in the same area. For illnesses requiring further treatment, patients are referred by family practitioners to second-level treatment facilities, which are ‘state’ and ‘university’ hospitals. There are 1,453 hospitals and 194,000 hospital beds in Turkey. 840 of these hospitals are built and operated by the MoH and are known as ‘state hospitals’. These hospitals constitute 57% of the current hospital stock and 62% of current hospital bed capacity in Turkey. There are 503 ‘private hospitals’ and 65 ‘university hospitals’.

There is an emerging group of hospitals that will be built and managed by the Public-Private-Partnership (PPP) model. The MoH has recently been contracting out the construction and management of 29 healthcare campuses around Turkey. Each campus will house 500 to 3,000 beds divided among general and specialized hospitals, laboratories, and accompanying recreational areas. You may get more information on these projects at http://www.saglikyatirimlari.gov.tr/

All people living in Turkey can benefit from being treated in these hospitals. If they are ‘universal healthcare insurance’’ holders, all of their expenses are reimbursed by the Social Security Institute (SGK) (www.sgk.gov.tr). Today, 95% of the population is covered under this insurance plan. SGK reimburses expenses incurred by using the treatment type and medical device listed in the Healthcare Implementation Communique (SUT). The SUT is revised every few years to include new medical technologies, equipment, techniques, and an updated reimbursement price list. In order for medical equipment to be listed in SUT, it has to be registered in the National Databank managed by the MoH.

Turkey has been leading a rather aggressive approach since 2005 towards establishing an electronic system to manage patients’ records, reimburse healthcare expenses, manage prescriptions flow, and use of tele-medicine for offering healthcare services to remote parts of the country. The Ministry of Health’s E-Health Department cooperates with industry to develop various software to reach a position where all elements of Turkish healthcare system will be integrated in the central system. At this point, the area where there is good potential for healthIT companies is in the area of business analytics through which patient data collected in hospitals can be analyzed by management to derive decisions.

Medical tourism is a new sector developing in Turkey, which is a triggering factor in the investments made by the private sector in healthcare. Increasingly, patients from Europe and the Middle East go to Turkey for medical treatment, as costs are more affordable. Increased emphasis on medical tourism will also have a positive impact on U.S. manufacturers as it will bring create avenues for medical equipment exports.

Best prospective areas for medical device and healthIT companies in Turkey are as follows: Advanced pre-screening and diagnostics devices, advanced point-of-care devices, advanced surgical devices, cancer treatment devices, wound management devices, surgical devices using robotics technologies, dental equipment, implants used in orthopedics and traumatology, HealthIT solutions especially for clinical decision systems, remote patient monitoring devices, telemedicine systems

Main Competitors

Imports of U.S. origin is about 12% of the total imports market in Turkey. The rest are mainly from the European Union, predominantly from Germany, Italy, United Kingdom, France and the Netherlands, and China and India. There is also an emerging group of medical device and equipment manufacturers in Turkey, which are active in the manufacturing of disposables, orthopedic devices and tools, surgical and cardiological tools; like stents. There are close to 100 healthIT software development companies.

Current Demand

 

2013

2014

2015
(estimated)

2016
(estimated)

Total Market Size

2,437

2,681

2,949

3,292

Total Local Production

550

605

666

799

Total Exports

307

338

371

427

Total Imports

2,194

2,413

2,655

2,920

Imports from the U.S.

296

326

358

394

Exchange Rate: 1 USD

2.15 TL

2.32 TL

2.60 TL

 

Total Market Size = (Total Local Production + Total Imports) – (Total Exports)

Data Sources: Industry feedback, Turkish Ministry of Industry reports.

Barriers

Turkey has Customs Union Agreement with the EU which provides that products exported from an EU country are not levied any imports tax when passing through Turkish customs. Countries that have Free Trade Agreement with Turkey also benefit from the same application. Products exported from countries not falling into either of these groups are levied imports tax at varying amounts. This is not a trade barrier but an extra factor that U.S. companies have to take into consideration when they are establishing their pricing strategies in Turkey. Turkey also sometimes pursues protectionist approaches in favor of some of its local industries (lately for furniture industry which has had negative impact on hospital beds imported to Turkey) which results in sudden increases in the tax rates it charges on related imported products.

Registration Process

Turkish medical device directives have been aligned to those applicable in the European Union (EU):

  • Medical Device Regulation(93/42/EEC)
  • Active Implantable Medical Device Regulation (90/385/EEC)
  • In Vitro Medical Diagnosis Devices Regulation (98/79/EC)

Per the directives listed above, medical devices have to have CE Mark in order to be registered and marketed in Turkey. They should have Declaration of Conformity and EC certification given by a Notified Body authorized by the EU.

Medical devices that will be sold in Turkey have to be registered in the Turkish Medicines and Medical that is operated by Turkish Drugs and Medical Device Agency under the Ministry of Health. If the manufacturer has a subsidiary in Turkey, medical devices, in question, can be registered under this entity’s name. If they are represented by a distributor in the country, this distribution company has to file in the registration under its own name.

Trade Events

EXPOMED Eurasia

March 24-27, 2016

Tuyap Fair and Congress Center

Istanbul/Turkey

http://www.expomedistanbul.com/en/

Government Links:

Ministry of Health

http://www.saglik.gov.tr

Turkish Drugs and Medical Devices Agency

http://www.titck.gov.tr/

Ministry of Health, Medical Devices and Drugs Databank (registration) http://titubb.titck.gov.tr/AnaSayfaV3.aspx?AktifDil=en

Social Security Institute (universal health insurance)

http://www.sgk.gov.tr

U.S. Commercial Service Contact Information

Name: Ebru Olcay

Position: Senior Commercial Specialist

Email: Ebru.Olcay@trade.gov

Phone: +90 212 335-9223


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