The document provides an overview of the healthcare and pharmaceutical industries in Turkey. It notes that Turkey has over 1,500 hospitals and 200,000 beds, with the majority run by the Ministry of Health. The pharmaceutical industry is the 18th largest globally and 7th in Europe, with over $16 billion in annual sales. The government has ambitious targets to increase healthcare access and expenditures by 2023.

1. Foreign Market Consulting Ltd. Sti.
Istanbul
August 2015
Healthcare and Pharmaceuticals Industry in
Turkey

2. Contents
© 2014 Foreign Market Consulting Ltd. Sti.
A Healthcare Services Page 03
B Pharmaceuticals Page 10
C Market Outlook Page 17

3. 3
• 1,517 hospitals
• 202,031 hospital beds
• 15% of the total number of hospitals, 29% of the private hospitals are located in
Istanbul.
A. Healthcare Services
Number of Hospitals & Beds
Source: Ministry of Health of Turkey, 2014
Ministry of
Health; 854;
56%
Private; 550;
36%
University;
69; 5%
Other; 44;
3%
Number of Hospitals by Sectors, 2013
Ministry of
Health;
121,269;
60%
Private;
37,983; 19%
University;
36,056; 18%
Other;
6,723; 3%
Number of Hospital Beds by Sectors, 2013

4. 4
A. Healthcare Services
Number of Healthcare Personnel
Number of Healthcare
Personnel, 2013
Ministry of Health University Private Sector Other Total
Physicians 75,496 28,312 28,466 1,501 133,775
Dentists 7997 967 13151 180 22,295
Pharmacists 2,067 291 24,589 65 27,012
Nurses 93,700 21,302 21,841 2,701 139,544
Other* 331,302 23,681 51,886 5,664 412,533
Total 510,562 74,553 139,933 10,111 735,159
*Incl. Midwives, other healthcare personnel and outsourced staff
Source: Ministry of Health of Turkey, 2014

5. 5
• CAGR in total hospital visit (2006-2013): 8.2%
• CAGR in private hospital visits (2006-2013): 24.4%
189.4
209.6
216.7
228.3 235.2
254.3 261
277.5
15.5
24.5
38.7
47.6 47.7
59.1
66.6 71.3
12.6
15 18.3
19.4 20.1 24.4 27.1 30
217.5
249.1
273.7
295.3
303
337.8
354.7
378.8
0
50
100
150
200
250
300
350
400
2006 2007 2008 2009 2010 2011 2012 2013
Hospital Visits
Ministry of Health Private University Total
mn
A. Healthcare Services
Source: Ministry of Health of Turkey, 2014
Number of Hospital Visits

6. 6
• CAGR (2006-2013): 7.0% in total inpatients; in total surgical op. 6.2%
• CAGR (2006-2013): 17.5% in private inpatients; in private surgical op. 15.1%
A. Healthcare Services
Number of Inpatients & Surgical Operations
Source: Ministry of Health of Turkey, 2014
5.3
5.7
6 5.9
6.4
6.8 6.9 7
1.2
1.3 1.4
1.5 1.5 1.6 1.6 1.6
1.2
1.8
2.3 2.5 2.7
3.1
3.5 3.7
7.7
8.7
9.7 9.9
10.5
11.4
12.0
12.4
0
2
4
6
8
10
12
14
2006 2007 2008 2009 2010 2011 2012 2013
Number of Inpatients
Ministry of Health University Private Total
mn
1985
2217
2464
1830
2039
2209
2299
2415
508 560 638
547 577 618 665 716
580
787
1087 1131 1215
1374 1447
1554
3073
3565
4189
3508
3831
4201
4410
4684
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
2006 2007 2008 2009 2010 2011 2012 2013
Number of Surgical Operations
Ministry of Health University Private Total
thousand

7. 7
A. Healthcare Services
Health Expenditures
24,279
30,021
35,359
44,069
50,904
57,740
57,911
61,678
68,607
74,189
84,390
10 000
20 000
30 000
40 000
50 000
60 000
70 000
80 000
90 000
20032004200520062007200820092010201120122013
Total Healthcare ExpendituresTRY mn*
CAGR: 13%
*EUR 1 = TRY 2.528 in 2013
Source: Turkish Statistical Institute, 2014
17,462
21,389
23,987
30,116
34,530
42,159
46,890
48,482
54,580
58,785
66,228
0
10000
20000
30000
40000
50000
60000
70000
20032004200520062007200820092010201120122013
General Government
Health Expenditures
TRY mn*
CAGR: 14%

8. 8
• All public hospitals were transferred to the Ministry of Health.
• Each citizen has a family-specific physician whom they may visit at any time and consult
on the phone whenever they want without paying any charge.
• All the citizens receive primary health care services free-of-charge.
• All the citizens receive service from private hospitals and medical centers through their
health insurances.
• Hospitals provide all medications and medical materials for inpatients as free-of-charge.
• Emergency and intensive care treatments free-of-charge in all public and private
hospitals.
• Decrease in the rate of people paying medicine and treatment expenditures out-of-
pocket: 32.1% in 2003; 11.7% in 2010.
• Satisfaction rate in public health services: 39.5% in 2003; 74.7% in 2013.
A. Healthcare Services
Health Transformation Program (2003)
Source: Ministry of Health of Turkey, 2014

9. 9
• Main Private Hospitals
A. Healthcare Services
Main Private Hospitals
Hospital Name Number of Hospitals
Medical Park 21
Acibadem 15
Medicana 11 (incl. 2 dental)
Memorial 7
Florence Nightingale 5
Bayindir 3
Medipol 2
American Hospital 1
Anadolu Health Center 1
Ankara Guven 1
Hisar Intercontinental 1
Kent Hospital 1
Yeditepe University
1
Source: Company web sites, 2015

10. 10
• Turkey is the world's 18th largest and Europe’s 7th largest pharmaceuticals market in
2013. (Source: AIFD and IMS Health, 2014)
• 68 pharmaceuticals manufacturing facilities in Turkey, 15 of them belong to foreign
capital firms. (Source: Ministry of Science, Industry and Technology, 2013)
• 12 raw material manufacturing facilities, 6 of them belong to foreign capital firms.
(Source: Ministry of Science, Industry and Technology, 2013)
• 30,000 employees. (Source: Ministry of Science, Industry and Technology, 2013)
• Main segments (2014 market share-value): Oncologics (11.2%), Antibiotics (8.5%),
antirheumatismal (6.3%), antidiabetics (6.3%), cardiovasculars (5.8%), blood-related
medicines (5.8%) (Source: IMS, IEIS, 2015)
B. Pharmaceuticals
Overview

11. 11
B. Pharmaceuticals
Domestic Market
*EUR 1 = TRY 2.909 in 2014
Source: IMS, AIFD, 2015
1292
1399
1477
1527
1570
1721
1769 1778
1822
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2006 2007 2008 2009 2010 2011 2012 2013 2014
Volume of the Pharmaceuticals Marketmn boxes
CAGR: 4%
9962
11588
12726
1484414790
15179
14450
15380
16557
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
2006 2007 2008 2009 2010 2011 2012 2013 2014
Value of the Pharmaceuticals MarketTRY mn*
CAGR: 7%

12. 12
B. Pharmaceuticals
Domestic Market
Source: IMS, IEIS, 2015
Generic
50.6%
Originator
49.4%
Breakdown of the Pharmaceuticals Market,
2014, Volume
Generic
29.6%
Originator
70.4%
Breakdown of the Pharmaceuticals Market,
2014, Value

13. 13
B. Pharmaceuticals
Domestic Market
Source: IMS, AIFD, 2015
Import;
26.5%
Local; 73.5%
Breakdown of the Pharmaceuticals Market,
2014, Volume
Import;
58.1%
Local; 41.9%
Breakdown of the Pharmaceuticals Market,
2014, Value

14. 14
• Main destinations of exports: Iran, Iraq, Germany, Switzerland and USA. (Source:
Ministry of Economy, 2014)
• Main sources of imports: Germany, USA, France, Switzerland and Italy. (Source:
Ministry of Economy, 2014)
B. Pharmaceuticals
Foreign Trade
Foreign Trade of Pharmaceuticals 2013 2014 2014/2013
Change %
Exports, USD mn 818 856 4.6%
Imports, USD mn 4,498 4,743 5.4%
Source: IEIS, 2015

15. 15
B. Pharmaceuticals
Main Manufacturers
Company Production-Based Net Sales (2014, TRY mn)*
Abdi Ibrahim Ilac 618.7
Bilim Ilac 568.4**
Bayer Turk Kimya 514.5
Deva Holding 405.2
Nobel Ilac 341.3
Kocak Farma Ilac ve Kimya 326.7
Santa Farma Ilac 204.9
Ali Raif Ilac 143.2
I. E. Ulagay Ilac 139.9
Adeka Ilaç 101.0
Biofarma Ilac 99.5
*EUR 1 = TRY 2.909 in 2014
** 2013 figure
Source: Istanbul Chamber of Industry, 2015

16. 16
B. Pharmaceuticals
Market Shares
Company Market Share, 2012
Abdi Ibrahim 7.5%
Novartis 7.0%
Sanofi 5.8%
Bilim 4.9%
Pfizer 4.3%
Bayer 4.3%
Eastpharma 3.8%
Glaxo 3.7%
Roche 3.4%
Astra Zeneca 3.0%
Source: AIFD and Investment Support and Promotion Agency of Turkey, 2014

17. 17
• Government Targets for Healthcare Indicators
C. Market Outlook
Government Targets for Healthcare Indicators
Criteria 2010-actual 2023-target
Maternal Mortality Rate (per 100,000) 16.4 6
Infant Mortality Rate (per 1,000) 10.1 5
Number of Physicians 120,000 200,000
Number of Midwife Nurses 163,000 400,000
Family Physicians 1 F.P. per 3,600 people 1 F.P. per 2,000 people
Per Capita Health Expenditures USD 556* USD 2,000
*Source: Turkish Statistical Institute and FMConsulting calculations, 2014
Source: Ministry of Health of Turkey, 2011

18. 18
• Domestic production of USD 23.3 bn (Domestic production in 2011: USD 5 bn)
• Foreign trade surplus of USD 1.3 bn (Foreign trade deficit in 2011: USD -4.1 bn)
• Becoming a net exporter with an export volume of USD 8.1 bn (Export volume in
2011: USD 587 mn)
• Market share of domestically manufactured products: 70% (48% in 2012).
• R&D investments of USD 1.7 bn (R&D investments in 2010: USD 60 mn)
• Becoming one of the top 20 countries in innovation capacity
• Becoming a regional management center and exporting management services
C. Market Outlook
2023 Targets
Source: AIFD, 2012

19. Confidentiality
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information to be handled confidentially, especially regarding the sources used.
Liability
FMConsulting receives information and data from third parties and presents the gathered data to its
customers. Thus, FMConsulting does not take any responsibility for the accuracy of any declaration or
precision of any gathered data.
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