Is the “social face” of AKP's pharmaceutical price reforms mostly instrumental? A progressivity analysis of household pharmaceutical expenditures in Turkey

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Çinaroğlu S.

PUBLIC HEALTH, vol.208, pp.18-24, 2022 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 208
  • Publication Date: 2022
  • Doi Number: 10.1016/j.puhe.2022.04.
  • Journal Name: PUBLIC HEALTH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, ASSIA, Abstracts in Social Gerontology, CAB Abstracts, CINAHL, Educational research abstracts (ERA), EMBASE, Geobase, Index Islamicus, MEDLINE, PAIS International, Pollution Abstracts, Psycinfo, Public Affairs Index, Veterinary Science Database
  • Page Numbers: pp.18-24
  • Hacettepe University Affiliated: Yes


Objectives: Redistributive health policies aim to orchestrate welfare distribution in response to the needs

of the underprivileged sections of society. Turkey has undertaken a massive pharmaceutical price reform

since 2009 to show a more appealing, positive side to its citizens. This investigation examines the welfare

implications of pharmaceutical price reductions on Turkish households.

Methods: Data from the Turkish Statistical Institute, pertaining to the national household budget survey

for 2003, 2009, 2015, and 2019, were collected and analyzed. Difference-in-difference estimators combined

with propensity score matching were applied to repeated cross-sectional microdata to evaluate the

impact of strict pharmaceutical price policy on households’ out-of-pocket (OOP) pharmaceutical


Results: The Kakwani index and the Lorenz and concentration curves revealed a coherently regressive

pattern and highlighted that vulnerable groups shoulder the burden of pharmaceutical expenditures

(KW2003 ¼ 0.49; KW2009 ¼ 0.61; KW2015 ¼ 0.62; KW2019 ¼ 0.52). Because of the positive and

significant interaction parameter obtained from caliper matching (0.06090, P < 0.05), the increase in OOP

pharmaceutical expenditure is high in households with catastrophic OOP health expenditure.

Conclusions: The effective use of fiscal capacity, the continual monitoring of the household poverty effect

of pharmaceutical price reductions, and the groundwork for a developmental pharmaceutical sector

industrial policy agenda are imperative to disseminating the benefits of universal health coverage and

constructing rationally conceived inclusive policies.