HEALTH ECONOMY FROM THE POİNT OF VİEW GÜVENÇ KOÇKAYA

Your books "Market Access in Pharma in Developed Markets" and "Market Access in Pharma in Emerging Markets" were ranked in the top 20 of the "100 Best Pharma Books of All Time" list in 2021. Can I get your thoughts on this success, which is a valuable reference for Turkish Health Economics?

In 2015, since there were no books on Health Economics and Market Access in the Health Economics literature, we decided to publish a book in this field. Due to the inadequacy of finding detailed resources on developing countries, we started regional research. The book "Access to Pharmaceuticals in Emerging Markets", in which regional research was published, was published in 2016. Subsequently, we published the book "Market Access in Developed Markets" for developed countries in 2018. Both of our books have not fallen below the top hundred since their publication. In 2021, it was even ranked among the top one hundred pharmaceutical books of all time on the BookAuthority website. Another book we have recently published is Pharmacoeconomics From Cinical Perspective. Our aim was to provide a more clinical perspective of pharmacoeconomics, that is, pharmaceutical economics. That book also made it into the first hundred.

May I know the source of your books?

It contains information about the entry of health technologies into the markets of countries, with a focus on pharmaceuticals. For example, if you want to sell a health technology, medical device or pharmaceuticals in Germany, you can find basic information in these books. The references are the legislation of the countries and our expert authors who have detailed information about the countries. In our books; You can access market access processes about the health economy of 14 developed and 21 developing countries.

On the basis of your experience in the field of health economics, may I get information about Turkey's market share and international position in the Pharmaceuticals and Medical Devices sector?

We see that Turkey's expenditure on health is parallel to its economic weight in the world. This fluctuates between approximately 1 percent and 0.8 percent. In summary, we can say that there is neither too much expenditure nor too little expenditure on a general economic scale. However, when we look at the per capita health expenditure or the ratio of health expenditure to GDP, we can say that Turkey spends less on health than it should. There may be many reasons for this situation. First and foremost, high population reduces per capita expenditure. It can be said that the tight price policy of the public sector causes this. Considering that 70-80 percent of health expenditure is made by the public sector, there is a market with suppressed prices due to the strict price policy implemented by the public sector. This is our position in the world in general. However, when we look at some specific diseases, especially genetic diseases. The rate of consanguineous marriages in Turkey is much higher than in developed countries. When we look at regions such as the Middle East and North Africa, we see lower rates but higher rates compared to Europe and America. For example, while there are 4000 patients with a genetic disease in a population of 300-400 million in Europe, we can see that there are 5 thousand patients in a population of 80 million in Turkey. We see that the frequency of genetic diseases in Turkey is above normal. Since the cost of such diseases is higher, there may be some problems with these products. Normally, our pharmaceutical market share is about 1 percent in the world, but in such products, we can be 5 or 10 percent of the world market, depending on our population and economy. When we exclude genetic diseases, we do not have a big problem, but when we include genetic diseases in this pot, we see that we are a difficult market.

In 2019, you founded ECONIX, a research and consultancy company. What led you to establish ECONIX?

ECONiX Research was founded in 2019 and today, as it completes its fifth year, it has a separate company in Estonia and an office in Tunisia. Moreover, it has turned into a company that conducts health economics and market access research not only in Turkey, but also in the countries I define as Roman and Ottoman Geography, emerging markets, health economics and market access research. Although this is the case, in a geography extending from Slovenia to Algeria, Mogolia in the East and Saudi Arabia, Turkey has the largest share in terms of health expenditures among these countries. ECONIX carries out research mainly in the Turkish market, 70-80 percent, and 20-30 percent in the other countries mentioned above.

What is the distribution of private and public institutions that ECONIX serves?

We mainly work with international pharmaceutical and medical device companies. We also work with universities in projects funded by the World Bank or the European Union that can benefit the public. In summary, we can say that we cooperate directly or indirectly with academia and the public sector, although the private sector is predominant.

What is the latest innovation developed in ECONIX's research centres?

We see every research we conduct as an innovation for the stakeholders we work with. In the field of health economics in Turkey, we have developed an application platform called ECONALIX, where anyone can access the interface to conduct cost effectiveness and budget impact analyses free of charge for use in their academic studies. They can perform cost effectiveness with the Decision Tree methodology, which is most frequently used in health economics analyses. They can perform sensitivity analyses with the Tornado method. Another application is the drug data bank. In this data bank, you can track historical prices, weekly changes and conduct pharmaceutical oriented research in Health Economics. ECONALIX was our first project. It was supported by KOSGEB and we successfully completed it in 2021. We had a second project in 2022, and in that project, our aim is to add medical devices and healthcare services to our ECONALIX application and improve our data set. After adding them, we are working on a web based application that will use the Markov method, both to expand our database and to upgrade the application we use for decision tree analysis. In the coming years, we will be offering it to the service of the Turkish academia and we aim to make it free of charge.

What are your future plans for ECONIX Research Company?

When we set out on this journey, we aimed to grow not only in Turkey but also in our neighbourhood and we are trying to achieve this. While we are trying to achieve this goal in our first 5 years, our goal in the next 5 years will be to make ECONIX the first preferred institution in public and private institutions in the health sector.