AIFD Working Bodies

Health Economic Policies

AIFD HEP SMC regular monthly meetings took place as planned in April 2021. AIFD position on reimbursement processes and commissions and decision of Plenary Session of the Administrative Law Chamber on SSI Regulation on Alternative Reimbursement and the results of AIFD Market Access Survey were discussed.

AIFD Position on Reimbursement Process and Commissions

A subgroup was formed within Reimbursement Task Force and Price Task Force and worked on the AIFD position on the reimbursement processes and working procedures and principles of the commissions. AIFD received members’ opinions about the SSI Regulation on Drug Reimbursement, the Procedures and Principles Regarding Drug Reimbursement Applications, the SSI Regulation on Alternative Reimbursement for Universal Health Insurance and the Regulation on the Working Procedures and Principles of the Social Security Institution Healthcare Services Pricing Commission. The subgroup worked on the members’ feedback. The final documents are to be submitted for HEP SMC until May 7 ^th.

On the other hand, SSI has completed the draft studies on relevant regulations and will receive the feedback of the industry. AIFD feedback on Regulation on the Working Procedures and Principles of the Social Security Institution Healthcare Services Pricing Commission was submitted to the Union of Chambers and Commodity Exchanges of Turkey (TOBB) on April 16 ^th.

Decision of Plenary Session of the Administrative Law Chamber on SSI Regulation on Alternative Reimbursement

All Pharmacist Employers Union (TEİS) had filed a lawsuit for the cancellation of some articles of the SSI Regulation on Alternative Reimbursement. The main reasons were:

• The confidentiality decision was taken in an area with uncertain borders and duration without any legal basis, legal security was damaged, and the regulation was uncertain and arbitrary
• The decision of determining and concealing the discount rate, other than the public institution discount rates determined in the Healthcare Implementation Communique (SUT), is the authority of the Commission and this regulation is a violation of authority
• The regulation may be in favor of the institution or against it
• The issue of hiding is against the transparency principle in the transactions of the administration, and confidentiality would prevent pharmacists from taking measures to avoid economic damage
• The regulation would make healthcare provision poor quality and would not serve the purpose of overriding public interest

The Council of State 15th Administrative Law Chamber had decided to dismiss the case, stating that the articles subject to the case were in compliance with the underlying Law article, that there was no violation of the law, higher norms, public interest. All Pharmacist Employers Union (TEİS) brought the case to a higher jurisdiction. The Council of State Plenary Session of the Administrative Law Chamber has recently decided to reverse the decision of the 15th Administrative Law Chamber and send the file to the Chamber for a new decision.

The Social Security Institution may tend to postpone the transactions carried out in accordance with the regulations subject to cancellation. The Social Security Institution may choose to prepare a new Regulation by taking into account the legal regulations referred in the Council of State decision and by taking the opinion of the Ministry of Health. AIFD is to contact the SSI regarding the possible actions of the Institution.

AIFD Market Access Survey

The responses for the survey were received in March and April and the preliminary results were discussed at the SMC meeting. 32 out of 34 member companies contributed to the study and approximately 180 reimbursement applications were analyzed. The results of the survey were shared with all member companies in early May.