Publication: Türk Sosyal Güvenlik Sisteminde ilaç sorunu
Abstract
Harcamaları, İlaç Sektörü, Sağlık Harcamaları, Sağlık Hizmetleri, Sağlık Sigortası, Sağlık Sistemleri. ÖZET TÜRK SOSYAL GÜVENLİK SİSTEMİNDE İLAÇ SORUNU 20. yüzyılın ikinci yarısında, sağlık bilincinin artması, yaşam süresinin uzaması, kronik hastalıkların yaygınlaşması, tıptaki ilerlemeler gibi faktörlerin sonucunda tüm dünyada sağlık harcamaları artmıştır. Sağlık harcamaları içinde en önemli kalemlerden birini ilaç harcamaları oluşturmuştur. Tedavi süreçlerinin ve yeni ilaçların pahalılığı, özellikle Türkiye gibi gelişmekte olan ülkelerde ilaç harcamalarını artırmıştır. Bu çalışma ile ülkemizde ilaç harcamalarının son yıllarda ulaştığı yüksek seviye ortaya konulmaya çalışılmıştır. Tarihsel süreçte toplumun ve devlet mekanizmasının ilaç harcamalarını karşılamak için geliştirdiği sosyal güvenlik yöntemlerinin incelendiği çalışmada refah devletinin kriz yıllarında dünyada ve ülkemizde ilaç harcamalarını kısmaya yönelik çabalar da ele alınmıştır. İstatistiksel verilerin incelenmesi neticesinde ulaşılan bazı dikkat çekici sonuçlar şu şekilde özetlenebilir: •Son otuz yılda OECD ülkeleri içinde Gayri Safi Yurt İçi Hasıladan Toplam Sağlık Harcamalarına giden payın en çok arttığı ülkelerden birisi Türkiye’dir. •Türkiye ilaç piyasası, son yıllarda dünyada yükselişe geçen 7 piyasadan biri haline gelmiştir. Bu yedi ülke içinde ilaç tüketimini kamu ile sağlayan en önemli ülke Türkiye’dir. •1990’ların başında Türkiye’de ilaç harcamalarının kamu sağlık harcamaları içindeki oranı % 20 civarındaki iken 2000’lere gelindiğinde bu oran % 40’ları aşmıştır. İlaç harcamalarının artmasında etkili olan temel faktörler ise akılcı olmayan ilaç kullanımı, etik dışı davranışlar ve sistemin sürdürülebilirliğini kısıtlayan resmi politikalar olarak sayılabilir. İlaç harcamalarında artış eğiliminin önüne geçilebilmesi için şu tedbirlere başvurulmuştur: yeni fiyat kararnamesi, eşdeğer ilaç tercihine ağırlık verilmesi ve geri ödeme politikalarının yeniden düzenlenmesi. Drug Expenditures, Health Expenditures, Health Insurance, Health Services, Health Systems, Pharmaceutical Sector.
THE DRUG PROBLEM IN THE TURKISH SOCIAL SECURITY SYSTEM In the second half of the twentieth century, as a result of factors such as increased health consciousness, prolonged life expectancy, spread of chronic disease, advances in medicine, health expenditures has increased all over the world. One of the most important item in health expenditures has been drug expenditures. The expensiveness of the treatment processes and new drugs, especially in developing countries like Turkey, have increased drug expenditures. In this study, it is tried to put forward our country has reached a high level of drug expenditure in recent years. The social security methods that was developed by society and government to meet the drug expenditures in the historical process and the efforts to cut spending on drugs in the world and our country during the crisis of the welfare state, is examined in the present study. As a result of statistical analysis of the data achieved, some remarkable results can be summarized as follows: •In the last thirty years, Turkey has been one of the country in OECD countries, which the share of Total Health Expenditure in Gross Domestic Product has increased most. •In recent years, Turkey pharmaceutical market, has become one of the 7 market which has rised in the world. Turkey is the most important country within the seven countries, that drug consumption was provided by the public. •The share of drug expenditures in the public health expenditures in Turkey was about 20% in early 1990s, but in the 2000s this ratio has surpassed the 40s%. The irrational use of drugs, unethical behaviors and official policies that limits the sustainability of the system can be considered the main factors which increases drug expenditures. The new price decree, supporting the use of generic medicines and rearrangement of drug reimbursement policies have been taken to prevent rising tread of drug expenditures.
THE DRUG PROBLEM IN THE TURKISH SOCIAL SECURITY SYSTEM In the second half of the twentieth century, as a result of factors such as increased health consciousness, prolonged life expectancy, spread of chronic disease, advances in medicine, health expenditures has increased all over the world. One of the most important item in health expenditures has been drug expenditures. The expensiveness of the treatment processes and new drugs, especially in developing countries like Turkey, have increased drug expenditures. In this study, it is tried to put forward our country has reached a high level of drug expenditure in recent years. The social security methods that was developed by society and government to meet the drug expenditures in the historical process and the efforts to cut spending on drugs in the world and our country during the crisis of the welfare state, is examined in the present study. As a result of statistical analysis of the data achieved, some remarkable results can be summarized as follows: •In the last thirty years, Turkey has been one of the country in OECD countries, which the share of Total Health Expenditure in Gross Domestic Product has increased most. •In recent years, Turkey pharmaceutical market, has become one of the 7 market which has rised in the world. Turkey is the most important country within the seven countries, that drug consumption was provided by the public. •The share of drug expenditures in the public health expenditures in Turkey was about 20% in early 1990s, but in the 2000s this ratio has surpassed the 40s%. The irrational use of drugs, unethical behaviors and official policies that limits the sustainability of the system can be considered the main factors which increases drug expenditures. The new price decree, supporting the use of generic medicines and rearrangement of drug reimbursement policies have been taken to prevent rising tread of drug expenditures.