A New Era in Pharmaceutical Pricing: Reforming Market Incentives

Presidential Decision No. 11031 dated 12 March 2026 (“New Pricing Decision”) introduces major changes to the pricing system for human medicinal products, originally established by Decision No. 2017/9901 and updated multiple times. Its main elements are an increase in the Euro/TRY adjustment rate from 60% to 65%, higher pricing incentives for first equivalent or generic products, and the introduction of the term "value-based pricing" in Turkish legislation for the first time.

Previously, the Turkish Lira value of the Euro for pricing human medicinal products was 60% of the previous year’s average Euro value. The coefficient is now raised to 65% for the first time in years. Until 1 April 2026, the Euro value will temporarily remain at 60 percent. From 1 April 2026, the Euro/TRY rate will be 29.1164 TRY. While this adjustment addresses a long-awaited sectoral concern, it remains insufficient to fully resolve patient access issues, particularly for innovative therapies. Considering Türkiye’s reference exchange rate mechanism and the limited public pharmaceutical budget, this increase alone is unlikely to provide a sustainable solution. OECD data indicate that both the share of pharmaceutical spending in Türkiye’s healthcare expenditures and per-capita pharmaceutical spending remain below many OECD countries. Therefore, exchange rate adjustments alone cannot improve access, and the public pharmaceutical budget also requires strengthening.

The New Pricing Decision introduces a new incentive system allowing higher pricing for the first equivalent or generic products to enter the market. Normally, generic medicines are priced up to 60% of the lowest-priced EU reference product. Under the new system, first equivalent or generic products can receive 80% of the reference price in year one, 75% in year two, and 70% in year three. If locally manufactured generics achieve certain market-share thresholds in years two and three, these percentages may increase. This approach resembles the U.S. system where the first generic benefits from temporary market exclusivity and is now implemented in Türkiye as a pricing advantage.

Flexible pricing mechanisms continue to apply for products such as blood products, allergy products, orphan drugs, biosimilars, vaccines, medicines critical to public health, and those under alternative reimbursement arrangements. In addition, “value-based pricing” has been introduced in Turkish legislation, signaling that value-based pricing and reimbursement methods, which the innovative pharmaceutical industry has advocated for many years, can now be implemented.

Transition details are critical. The new pricing system will be gradually implemented throughout 2026, with Euro/TRY calculations and certain price thresholds updated on specific dates. Tiered rates for equivalent products will apply only to products launched after the Decision enters into force. Existing products will retain current pricing during the transition.

The current Communiqué on the Pricing of Human Medicinal Products (“Communiqué”) remains in effect for provisions not conflicting with the Decision until a new Communiqué is published. Companies must closely monitor updates regarding pricing applications and changes to ensure compliance during the transition. Full adoption of the new system will become clear once temporary arrangements are concluded and the secondary legislation, namely the Communiqué, is updated.