Hasan KAVAK - We aim to improve human health and make a difference in the experience of patients.

Are you tell us about the activities of MEALIS in Turkey and the Middle East?

We are the distributor of X-ray and MR contrast agents produced by Mallinckrodt company, contrast agent injectors for radiology and cardiology and Laser navigation devices that guide the CT initiatives produced by Neorad company in Turkey. In addition, we are doing the supply, promotion and distribution of In Vitro Fertilization and Birth Control products of MSD company in Turkey, we are the distributor in Turkey of ITG in the field of nuclear medicine and we are representative in Turkey of product used for SISI and endometrium sampling belonging to Crossbay company for which we are the distributor in the field of women’s health, and of Cavaterm used in endometrial thermal ablation therapy of Veldana Medical. We have franchises of Falcon brand products used in IVF procedures. The operation of our company is carried out by a special team that has gained business experience in the sector for many years, has advanced expertise in the pharmaceutical and medical devices market, is in line with ethical policies and has the ability to do business at international level. MEALIS's professional team focuses on highly motivated, solution-focused and individual customer service with extensive knowledge of the region, business requirements and needs. Our team has the necessary competence and knowledge in sales, marketing, distributorship and project management.

Could you tell us about your new products and new business areas?

Mealis is a fast growing young company with firm steps. The primary goal of MEALIS is to maintain its position as one of the most important representatives on imaging in the Middle East and Turkey with its heritage, skills and strong communication network in radiology / imaging. Except for its constant focus on radiology, Mealis assesses potential development opportunities in areas such as Women's Health, Nuclear Medicine and Food Supplements products without any limits. We will continue to develop our product portfolio in line with our strategy in 2016. In addition, our efforts for domestic drug production are continuing rapidly.

What are the sectorial problems that arise from the difference between the fixed exchange rate at which the Ministry of Health implements while determining drug prices and the actual exchange rate? How are the budget constraints reflected in the activities?

The fixed exchange rate policy applied in the pharmaceutical industry is a very difficult burden to manage for the industry. Pricing and reimbursement policies must be implemented primarily to ensure that pharmaceutical companies get the profit which they deserve in order to produce new products by investing in production and R & D, not to be back in the global competition and to make a positive contribution to foreign trade balance. The pressure on the public finance of increasing drug expenditures is being balanced by the continuous reduction of medicine prices. In addition to falling prices and rising discounts, pharmaceutical companies are trying to manage this process, where exchange rate is increasingly growing by postponing / cancelling investments or reducing the number of employees. However, the point reached is far from being sustainable. The drug budget for sustainable pricing should be determined in accordance with the service offered and fixed exchange rate and existing reference system should be revised. The prices in the domestic market are not only domestic effects. At the same time, it affects export prices negatively. Sale price in the domestic market in Turkey are based in countries where drugs are exported

When drug prices are determined, does the applied exchange rate policy cause foreign capital to enter my country or end its activities?

Unfortunately, the new molecules, new medicines which are presented to the patient's service as a result of long, troublesome and very high investments can no longer enter the market in Turkey and are becoming available only to a limited number of patients. As a consequence of this in the long run, patients' access to new and innovative medicines in our country may become very limited. I think that the ecosystem needs to be made strong, predictable and sustainable in the innovative pharmaceutical industry based on research and development that contributes to our long-lasting, more active and better quality of life. Actually, it is clear that innovative medicines reduce health spending per person in the medium and long term and have contributed more positively to the national and family budgets when considering factors such as hospitalization, surgery, complications or patient care and recovery. If a predictable and balanced budget is not established and if there are not strong intellectual property protection and a sustainable price, it will not be possible for the pharmaceutical industry to continue to offer a single drug that has been ongoing for years in the R & D process with billions of dollars investment. If we implement the necessary structural reforms and support our R & D and innovation in our health care system, I believe that the pharmaceutical industry will work together and will be one of the most important actors on the way to our government's 2023 goals. Turkey could become a management, production, innovation and event R&D Center in the region. I think that we have more than this powerful potential. It seems that the policies that are being pursued at this moment are providing serious and positive developments in this sense.

What kind of solutions do drug manufacturers produce because of the difference between the real exchange rate and the fixed exchange rate?

In order to reduce costs, producer companies are looking for alternative and cheaper alternative sources for cost items. The biggest item that makes up the costs is the raw material, so it is going to cheap raw materials. This can sometimes cause question marks in drug quality. Not only raw material, but also the excipients used in the production of medicine, packaging material and even the container to which the medication is delivered must be in a certain standard. For this reason, the savings to be made in these items will also cause great quality problems at the same time. Companies that are focused on sales marketing also reduce staff numbers to minimize staff expenses, unfortunately.

Does this make it difficult for the patient to reach the original drug?

I think that we can put this out more clearly on the numbers. Only 29% of the molecules and compounds presented to the patients in these countries by completing the FDA and EMA processes between 2005 and 2011 were accessible in the same period in Turkey. This value has decreased to 4% in the second quarter of 2013. It is currently at the level of 2%. When considering the right of access to drug and human life, we need to find out why American and European patients have more access to innovative drugs than Turkish people

There is also a current account deficit problem from the drug, is not it?

With effect of the policy of localization in the pharmaceutical industry observed in 2010-2015 period, exports of Turkey pharmaceutical industry increased by 9.8 percent and reached 939 million US dollars. Thus, the rate of exports meeting imports reached 20.3 percent, reaching the highest rate in 2010-2015 and the pharmaceutical industry has contributed positively to the reduction of current account deficit. The figures tell us, "Yes, there is a serious current account deficit in medicine." However, I hope that this positive trend, which is being caught at this point, will be a long time and that this current account deficit will decrease rapidly with the high technology products we export.

Do government officials have any work on raising drug prices?

As you know, the Euro exchange rate was fixed at 1,9595 from April 2009 until May of the last year. As the results of gain of cases opened by the drug manufacturer, euro rate used in drug pricing had to be increased. Fixed exchange rate has been gradually increased from 2,00 to 2,0787 and currently to 2,1166 since May 2015. Of course, there was a much smaller increase than expected by pharmaceutical companies. “The prices to be calculated over 70% of the Euro averages of the previous year” which will be implemented from 2016 is partly sensitive to exchange rate changes, but in the end it is still a rate fixing mechanism. In addition, SSI has reorganized discount rates on certain medicines, ensuring that products with low prices are at least available on the market.

What do you think about the current situation of the pharmaceutical sector in Turkey?

Products imported currently by Turkey are products such as biotechnology, oncology, blood products requiring new and high-tech. However, I believe that the production and development of such products can be realized in Turkey as a result of developing and continuing support for production and R & D. Turkey has not yet achieved sufficient competitiveness in the pharmaceutical sector as in many other areas. Total pharmaceutical market in Turkey reached TL 16.87 billion in 2015 with 15.5% growth. On the box scale, a growth of 6.7% was realized as 1.95 billion volumes.

Turkey has a great potential in the pharmaceutical sector. Are there sufficient investments in R & D, innovation and branding?

Our country has always had a high potential in attracting significant investments, being the center of R & D, production and management. However, these opportunities will not arise spontaneously because Turkey has serious potential or because the market in Turkey is large. Opportunities can only be realized with industry-friendly long-term vision and parallel policies. I think that we, as managers, should not seriously struggle to make our country more preliminary in these fields with our own companies. I am sincerely convinced that within the vision of 2023, the health and pharmaceutical sectors can be real locomotives. Therefore, I attach great importance to the strategy plans and cooperation activities carried out with different ministries, especially our Ministry of Health and I consider it to be the duty of all of us to be supported to implement them. But I think it would be useful to say this. Turkey stands out in important health parameters within the framework of the health transformation project and is followed by many countries as an example. In this context, ensuring rapid access to innovative medicines on a regular basis will benefit all stakeholders.

How do you look at social media which the industry is now also involved and communication and market activities are conducted or what kind of work do you plan?

Social media is an inevitable part of the sectorial life as much as it is in personal life. When it comes to health communication, the first thing to come to mind is doctor-patient communication. However, it is very important for the messages to reach the stakeholders through different means from more than one channel, to make people aware of the diseases and treatment methods and to be supported by technology. Social media has brought a new dimension to the sector in terms of being a fast and easy way of communication. Of course, using this way in a correct and ethical way is indispensable. Our company also has accounts that can be followed in social media and we have plans to further develop with new applications in the coming period.

What are the most important issues that will affect the pharmaceutical industry in 2016?

I think that applications in the main fields of pharmaceutical industry such as licensing, pricing, reimbursement and clinical research will continue to be important. In addition, the objectives of increasing domestic production capacity and development of R & D and enterprise ecosystem will also be important issues that will affect the pharmaceutical sector within the scope of the tenth development plan

What do you think about the restrictions brought by the Ministry of Health on drug promotion?

We are very pleased with the necessity of being more educated, more conscious, more responsible of medical representatives and increasing ethical regulations in our country. We believe that all companies in the sector should act in line with both ethical values and ministerial regulations.