Decisions of the Healthcare Services Pricing Commission (“HSPC Decisions”) and Communiqué Amending the Social Security Institution Communiqué on Healthcare Practises have been published in the Official Gazette dated 8 February 2022 and numbered 31744 (Repeated). Main amendments made to the Social Security Institution Communiqué on Healthcare Practises (“CHP”) in accordance with the HSPC Decisions are summarized below. Amendments include important changes regarding healthcare services and equipment the costs of which are covered by Social Security Institution (“SSI”) and Spinal Muscular Atrophy (“SMA”) patients.
• Lists included in the Annex of CHP have been updated and amounts paid by SSI to healthcare institutions and organizations as treatment service fees have been increased at varying rates depending on treatment types. Accordingly, while fees have been increased around 35% for per case medical examinations, 45% for package treatments (except pandemic package), 50% for hemodialysis treatments and 40% for other treatments respectively; no increase has been made for the treatments related to the pandemic.
• Article 3.3 of the CHP titled “Principles of supply of some medical equipment” has been amended and amounts of the fees covered by SSI for medical equipment, orthosis and prosthesis have been increased. With the amendments, 75% increase has been made for the medical equipment used in the hospitals in general, this rate has been determined as 36% for the orthosis, prosthesis and medical equipment used by patients with foot diseases, and 27% for the medical equipment used under specific circumstances.
• Article 4.2.49 of the CHP titled “Principles of usage of nusinersen sodium in Spinal Muscular Atrophy Disease” has been amended and new rules have been set forth regarding SMA disease. Within this scope, criteria required for medicine costs of SMA Type-1, Type-2 and Type-3 patients to be covered by SSI have been reintroduced. In this way, criteria regarding the further use of medicines containing “Nusinersen Sodium” active ingredient have been updated and more patients have been enabled to take the next doses.
• Phrase of “or changes that may occur in reference status” has been decided to be removed from the provision of Article 4.4.1 of the CHP titled “Discount rates that will be applied for medicines and generic medicine implementation” which previously had the provision of “However, through the commission, Agency evaluates update requests regarding the discount rates for any changes that may cause an increase in the public price due to reasons such as the changes in the status of the reference product, generic product, product with price protection or changes that may occur in reference status, which are published in the Turkish Medicines and Medical Devices Agency Detailed Medicines List while they are listed in the CHP annex Annex-4/A list.”
• Molecular cytogenetic surveys have been included in the scope of the cytogenetic surveys and oncologic molecular surveys have been included in the scope of the molecular surveys which are provided in Article 2.4.4.G of the CHP, and codes specific to the diseases and genes have been added.
• Moreover, an addition has been made to (pp) subparagraph of paragraph three of Article 4.2.14.C of the CHP and non-small cell lung cancer indication has been included within the scope of reimbursement-covered indications of “Nivolumab”, which is currently in the reimbursement list, on the condition that it satisfies certain criteria.