ALTERNATIVE REIMBURSEMENT SYSTEM
The alternative reimbursement system stands out as an important option for access to innovation. The alternative reimbursement system is often defined as a contractual agreement that demonstrates the real-life effectiveness of new technology and allows the share of risk between the reimbursement institution and the company by determining its value.
There is already a Regulation in Turkey that establishes the legal infrastructure of alternative reimbursement agreements. The Regulation defines the working procedures and principles of the Commission responsible for the evaluation process, the duties of the commission and its members and the principles of the implementation.
During the evaluation phase, the treatment costs of the products for which reimbursement applications are made, are sometimes compared not to the comparative therapeutics used in the clinical trials but with therapeutical alternatives existing in the same ATC classification with multiple marketed generics. As a result of such comparison, products whose prices are found higher than these therapeutical alternatives are subject to additional institutional discount requests, and the products could be listed with SUT conditions that are incompatible with the place of the products in the treatment guidelines and the patient profile that needs such products.
In alternative reimbursement evaluations, it is observed that a budget effect-oriented method is followed while clinical efficacy data are not adequately taken into account. This approach is an important obstacle in determining the true value of the innovative product.
