Turkey - Country Commercial Guide
Medical Technologies and Health IT

This is a best prospect industry sector for this country. Includes a market overview and trade data.

Last published date: 2020-10-07

Overview

 

2018

2019

2020 (est.)

2021 (est.)

Total Local Production

778

929

667

676

Total Exports

494

543

597

656

Total Imports

1,605

1,501

1,483

1,504

Imports from the U.S.

377

300

296

300

Total Market Size

1,889

1,877

1,854

1,880

(total market size = (total local production + imports) - exports)                                

Unit: USD (millions)

With a population of 83 million, Turkey is a growing market for medical technologies and healthcare services. The Ministry of Health (MoH) is responsible for planning and implementing the country’s healthcare policy and is also the largest healthcare service provider. Turkey spends 4.5% of its GDP on healthcare; $30 billion in 2018. This rate is relatively low compared to the 8.8% OECD average and indicates room for growth in healthcare spending. Turkey is a major importer of medical technologies, with imports accounting for 85% of medical devices, 20% of which come directly from the United States. The Government of Turkey (GoT) has been able to manage currency losses, an issue since 2018, and an increasing demand for healthcare services, by maintaining steady reimbursement prices for medical devices. This, however, has caused problems for foreign firms as they must contend with these low and steadily decreasing rates (when accounting for inflation and currency fluctuations).

The GoT’s goal is to increase the country’s skill set and knowledgebase to manufacture medical devices domestically. To realize this, Parliament passed a law giving procurement guarantees to products purchased from medical device companies that partially or wholly manufacture in Turkey. The first group of products subject to this procurement model were MRI, CT, digital x-ray, ultrasound devices and patient monitors. The winner of this tender would receive a five-year procurement guarantee in return for sourcing local parts initially, partially manufacturing in the second year, and then gradually increasing local content. The GoT has encouraged partnering with a Turkish company to form a consortium. However, after seven cancellations and no new tender date announced, there is a general sense of uncertainty surrounding this procurement. The GoT’s objective to increase local production is expected to continue, but the means of incentivizing it may change.

The MoH is responsible for the construction, management, and medical operations of public hospitals, where 90% of the population receives medical care. Patients who can afford private healthcare are covered under private insurance plans. Those with social security insurance may also be treated in private hospitals that have agreements with the Social Security Institute (SGK).

Healthcare expenses of social security beneficiaries treated at public hospitals are reimbursed by the SGK if medical equipment and pharmaceuticals used are included in the reimbursement (SUT) list. Medical equipment manufacturers who want to be part of the reimbursement system must ensure that their equipment is included in this list. Private hospitals do not necessarily follow this listing and manufacturers deal with these hospitals on an account basis.

Ownership distribution of hospitals in Turkey:

 

2002

2018

Growth %

Type

Hospitals

%

Hospital Beds

%

Hospitals

%

Hospital Beds

%

Hospitals

Hospital Beds

Min Health

774

67%

107,394

65%

889

58%

135,651

61%

14.8%

26.3%

University

50

4%

26,341

16%

68

5%

42,066

17%

36%

59.6%

Private

271

23%

12,387

8%

577

37%

50,196

21%

129%

305%

Other

61

6%

18,349

12%

0

0%

0

0%

-100%

-100%

Total

1,156

 

164,471

 

1,534

 

231,913

 

32.6%

41%

The MoH is the largest investor in and operator of healthcare facilities. However, there is a strong privatization trend. With more private hospitals, there are increased sales opportunities and, compared with MoH hospitals; the procurement requirements are less complicated and the payment terms are shorter.

The MoH also uses the Public-Private-Partnership (PPP) model to build new public hospitals, which are known as ‘city hospitals’ or ‘health campuses.’  The MoH planned to build 18 such hospitals by the end of 2021; 11 are operational and the remaining seven will be open in 2021. These hospitals will replace and renew about 50,000 beds in the current hospital bed stock. These PPP investments stipulate that the winning contractor will finance the construction and operate it for 25 years against guaranteed annual lease payments from the MoH. Each campus has 500 to 4,000 beds and houses several general and specialized hospitals and labs with accompanying recreational areas. These projects constitute business opportunities for U.S. medical device companies.

Another major transformation in the Turkish healthcare system is the introduction of first-level healthcare services, known as the Family Practitioner System. In December 2010, a nationwide system was initiated whereby every Turkish citizen was assigned a family practitioner for primary and preventative medical care. This service has already increased demand for pharmaceuticals and preventative medical solutions and devices for management of chronic illnesses such as obesity, diabetes, and many others where U.S. companies have solution offerings.

Medical tourism is a rapidly developing sector in Turkey. Increasingly, patients from Europe and the Middle East travel to Turkey for medical treatment as high-quality healthcare services are offered at economical prices. In 2018, 750,000 international patients visited Turkey and the MoH expects this number to reach 1,500,000 by 2023. Not including the United States, Turkey has the third highest number (46) of Joint Commission International (JCI)-certified hospitals. The most popular procedures are cosmetic, dental and ophthalmology procedures. Turkey also has a good reputation in cardiology, endocrinology, gastroenterology, rheumatology, nephrology, oncology, neurology, dermatology, gynecology/obstetrics, orthopedics, organ transplantation, and otolaryngology (ear, nose and throat). As some of these surgical procedures have long waiting lists in European countries, Turkey is an attractive country for medical procedures.

Despite the financial burden that the COVID-19 pandemic has placed on the Turkish economy, the GoT has not indicated a slowdown in healthcare investments. In fact, they accelerated the opening of the largest (3,000+ beds) health campus in Istanbul, inaugurating it in May 2020 with Japanese investment. The MoH has also contracted construction of two epidemic hospitals in Istanbul, which will be used not only for COVID-19 cases, but also for any other natural disasters. Each has 1,000 beds and is fully equipped with advanced diagnostics and imaging devices.

Turkey has taken a very progressive approach towards utilizing health IT solutions in the country’s healthcare structure. The MoH employs software developers for many of the health IT tools it launches; it also works with software companies on a contractual basis. Every citizen’s healthcare information (doctor visits, diagnostics, treatments, prescriptions, etc) is recorded in an Electronic Health Record (EHR). The system produces e-prescriptions to be filled at pharmacies, also making it possible for pharmacies to claim receivables from the Social Security Institute online. Data collected throughout the country is centrally stored on MoH servers. The MoH’s ‘e-pulse’ application grants citizens access to their healthcare record, gives privileges to healthcare professionals to access a patient’s EHR and connects some remote monitoring devices. The MoH uses this data to forecast population health management and to analyze illness patterns. The MoH has additional initiatives to reduce diagnostic errors, support telemedicine, and assess public hospitals.

For a U.S. company to market its medical equipment and health IT solutions in Turkey, it should find representatives in the Turkish market with strong business development capabilities. Turkey adopted the EU’s CE Mark and medical device directive, which require that medical devices bear the CE Mark in order to enter the Turkish market. U.S. company representatives in Turkey must register products in the National Data Bank (UTS) that tracks all medical equipment marketed in Turkey. To learn more about registering in this data bank, e-mail the CS Turkey Commercial Specialist indicated below. If the product is under the reimbursement system, it should also be registered with the Social Security Agency.

Leading Sub-Sectors

Approximately 6,000 companies operate in the medical device and disposables market in Turkey. Local manufacturers primarily manufacture disposables, orthopedic implants, surgical tools, stents, prosthetics, surgical gowns, masks and drapes and hospital furniture. In early May 2020, after the pandemic hit, a Turkish consortium led by technology company Biosys launched the first local mechanical ventilator which was immediately installed in new health campuses. Development and manufacturing of laboratory reagents is are also growing in Turkey; now close to ten Turkish diagnostics companies have developed COVID-19 tests. In general, all major categories of medical equipment are present in the market, both in private and public hospitals. At this point, they seek state-of-the-art and innovative medical equipment and solutions. Turkey imports the following medical equipment and devices:

  • Advanced pre-screening and diagnostics devices
  • Advanced imaging equipment
  • Advanced point-of-care devices
  • Advanced surgical devices
  • Cancer treatment systems
  • Wound management devices
  • Dental equipment
  • Robotic surgery equipment
  • Radiation oncology devices
  • Mechanical ventilators
  • Health IT solutions, especially for critical decision-making processes
  • Remote patient monitoring devices
  • Telemedicine systems
  • Contact tracing systems
  • Facial Recognition Software for Contactless Patient Experience

Opportunities

Total bed capacity in Turkish hospitals exceeds 200,000. Privatization and transformation of the healthcare system with the establishment of new healthcare facilities under the PPP model, and ongoing MoH hospital projects present opportunities for U.S. companies involved in medical technologies and services. As Turkey continues to expand the number of private and public hospitals, purchases of advanced medical equipment will continue. With the onset of the COVID-19 pandemic, large private hospital chains have adopted telemedicine and virtual care solutions. This trend is expected to continue in the coming years. Given the prevalence of chronic illnesses in the society, and as a result of the pandemic, remote monitoring solutions to track patients will gain importance.

Web Resources

For further information on this section or for more on potential opportunities, contact:

Ebru Olcay

Senior Commercial Specialist – Healthcare Sector Lead

U.S. Commercial Service

U.S. Consulate Istanbul, Turkey

Ebru.Olcay@trade.gov
www.export.gov/Turkey