Brief information about Turkish healthcare & pharmaceuticals industry by 2014 including number of hospitals and beds, healthcare transformation program and government targets for healthcare indicators

1. Foreign Market Consulting Ltd. Şti. • Dede Yusuf Sok. No:11, 34453 Büyükdere Sarıyer İstanbul - Turkey
Tel: +90-212-3638 052 • Fax: +90-212-3638 517 • www.fmconsulting.com • info@fmconsulting.com
Foreign Market Consulting Ltd. Sti.
Istanbul
June 2014
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
• 1,483 hospitals
• 200,072 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
Ministry of
Health,
122,322,
61%
Private,
35,767, 18%
University,
35,150, 18%
Other,
6,833, 3%
Number of Hospital Beds by Sectors, 2012
Ministry of
Health, 832,
56%Private, 541,
37%
University,
65, 4%
Other, 45,
3%
Number of Hospitals by Sectors, 2012
Source: Ministry of Health of Turkey, 2013

4. 4
A. Healthcare Services
Number of Healthcare Personnel
Number of Healthcare
Personnel, 2012
Ministry of Health University Private Sector Other Total
Physicians 73,663 26,997 27,436 1,676 129,772
Dentists 7,291 1,012 12,913 188 21,404
Pharmacists 1,920 271 24,298 82 26,571
Nurses 92,118 20,287 19,792 2,709 134,906
Other* 313,775 20,163 51,262 665 385,865
Total 488,767 68,730 135,701 5,320 698,518
*Incl. midwives and other healthcare personnel
Source: Ministry of Health of Turkey, 2013

5. 5
189.4
209.6 216.7
228.3
235.2
254.3
261
12.6 15 18.3
19.4 20.1 24.4 27.115.5
24.5
38.7
47.6 47.7
59.1
66.6
217.5
249.1
273.7
295.3
303
337.8
354.7
0
50
100
150
200
250
300
350
400
2006 2007 2008 2009 2010 2011 2012
Hospital Visits
Ministry of Health University Private Total
mn
A. Healthcare Services
Source: Ministry of Health of Turkey, 2013
Number of Hospital Visits

6. 6
A. Healthcare Services
Number of Inpatients & Surgical Operations
Source: Ministry of Health of Turkey, 2013
5.3
5.7
6 5.9
6.4
6.8 6.9
1.2 1.3 1.4 1.5 1.5 1.6 1.61.2
1.8
2.3 2.5 2.7
3.1
3.5
7.7
8.7
9.7 9.9
10.5
11.4
12.0
0
2
4
6
8
10
12
14
2006 2007 2008 2009 2010 2011 2012
Number of Inpatients
Ministry of Health University Private Total
mn
1985
2217
2464
1830
2039
2209
2299
508 560 638
547 577 618 665
580
787
1087 1131
1215
1374 1447
3073
3565
4189
3508
3831
4201
4410
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
2006 2007 2008 2009 2010 2011 2012
Number of Surgical Operations
Ministry of Health University Private Total
thousand

7. 7
A. Healthcare Services
Health Expenditures
18 774
24 279
30 021
35 359
44 069
50 904
57 740
57 911
61 678
68 607
76 358
10 000
20 000
30 000
40 000
50 000
60 000
70 000
80 000
90 000
20022003200420052006200720082009201020112012
Total Health Expenditures
TRY mn
CAGR: 15%
Source: Association of Research-Based Pharmaceuticals Companies (AIFD), Ministry of Health and Social Security Institution, 2013
13270
17462
21389
23987
30116
34530
42159
46890
48482
54580
58640
0
10000
20000
30000
40000
50000
60000
70000
20022003200420052006200720082009201020112012
General Government Health Expenditures
TRY mn
CAGR: 16%

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; 74.8% in 2012.
A. Healthcare Services
Health Transformation Program (2003)
Source: Ministry of Health of Turkey, 2013

9. 9
• Main Private Hospitals
A. Healthcare Services
Main Private Hospitals
Hospital Name Number of Hospitals
Medical Park 16
Acibadem 15
Medicana 10 (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, 2014

10. 10
• Turkey is the world's 17th largest and Europe’s 6th largest pharmaceuticals market in
2012. (Source: AIFD and IMS Health, 2013)
• 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 (2013): Antibiotics (11.6%), oncologics (9.4%), cardiovasculars
(8.5%), antirheumatics (7.0%), nervous systemics (5.8%), antiasthmatics (4.9%)
(Source: IMS, IEIS, 2012)
B. Pharmaceuticals
Overview

11. 11
1292
1399
1477
1527
1570
1721
1769
1778
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2006 2007 2008 2009 2010 2011 2012 2013
Volume of the Pharmaceuticals Market
mn boxes
CAGR: 5%
B. Pharmaceuticals
Domestic Market
9962
11588
12726
14844 14790
15179
14450
15380
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
2006 2007 2008 2009 2010 2011 2012 2013
Value of the Pharmaceuticals Market
TRY mn*
CAGR: 6%
*EUR 1 = TRY 2.528 in 2013
Source: IMS, AIFD, 2014

12. 12
B. Pharmaceuticals
Domestic Market
Source: IMS, IEIS, 2014
Generic
52.0%
Originator
48.0%
Breakdown of the Pharmaceuticals Market,
2013, Volume
Generic
36.7%
Originator
63.3%
Breakdown of the Pharmaceuticals Market,
2013, Value

13. 13
B. Pharmaceuticals
Domestic Market
Import,
26.1%
Local, 73.9%
Breakdown of the Pharmaceuticals Market,
2013, Volume
Import,
47.7%
Local, 52.3%
Breakdown of the Pharmaceuticals Market,
2013, Value
Source: IMS, AIFD, 2014

14. 14
• Main destinations of exports: Germany, Iraq, S. Korea, Iran and Switzerland.
(Source: Ministry of Economy, 2013)
• Main sources of imports: Germany, USA, Switzerland, France, Italy. (Source: Ministry of
Economy, 2013)
B. Pharmaceuticals
Foreign Trade
Foreign Trade of Pharmaceuticals 2012 2013 2013/2012
Change %
Exports, USD mn 720 818 14%
Imports, USD mn 4,354 4,498 3%
Source: IEIS, 2014

15. 15
B. Pharmaceuticals
Main Manufacturers
Company Production-Based Net Sales (2012, TRY mn)*
Abdi Ibrahim Ilac 612.4
Bilim Ilac 570.1
Bayer Turk Kimya 518.0
Deva Holding 360.6
Kocak Farma Ilac ve Kimya 252.3
Nobel Ilac 240.9
Santa Farma Ilac 163.8
I. E. Ulagay Ilac 142.7
Ali Raif Ilac 106.4
Adeka I.laç 103.3
*EUR 1 = TRY 2.31 in 2012
Source: Istanbul Chamber of Industry, 2013

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.
Foreign Market Consulting Ltd. Şti. • Dede Yusuf Sok. No:11, 34453 Büyükdere Sarıyer İstanbul - Turkey
Tel: +90-212-3638 052 • Fax: +90-212-3638 517 • www.fmconsulting.com • info@fmconsulting.com