The MINT countries of Mexico, Indonesia, Nigeria and Turkey are fasting emerging as markets of tomorrow for Indian companies. Especially for Turkey , Indian pharma is a major source for its active pharmaceutical ingredients and semi-finished products.

However barring the API and the semi finished product industry this market is not attractive for formulation companies said Sriram Iyer, managing director, Valugen Pharma.

Even in APIs only EU drug master files are accepted. There are also approval delays from its regulatory authorities besides a slew of problems that Indian drug manufacturers engaged in bulk drugs exports face. Because of these factors many Indian pharma companies are transferring technology and engaging contract manufacturers to produce their products in Turkey, which is also home to a large and invincible domestic pharma market, he added.

“The pharma market is regulated by EU norms which is the baseline for all approvals. So a much needed qualification for Turkey entry for Indian pharma is to have a strong presence in the EU region,” pointed out Iyer.

Opportunities and challenges
According to international market observers, all MINT countries have the ability to become part of the leading 10 global economies by 2050. These regions are attractive from a pharmaceutical market opportunity because of an educated-young population on the one hand and senior citizens on the other. While the former is willing to splurge and experiment with the latest advances in drug delivery devices in medical care, the latter use regular drugs for life style disorders and mental health conditions.

But the political instability and war-torn parts of Turkey are a challenge to penetrate their pharma industry. Despite the economic crisis that impacted Turkey in 2001, the country has transformed its industrial landscape to spur local manufacture and even attract investments from European Union and parts of Asia. There has been adequate government support and sweeping restructurings in the healthcare that has enabled the private healthcare to emerge. The implementation of the Healthcare Transformation Program in 2003 is a case in point.

For the European Union, Turkey is much-sought after as a medical tourism market for spas and local medical expertise. Even patients from Iraq, Libya and Egypt flock to Turkey for healthcare, added the international market experts.

According to a media report, by 2023, Turkey’s Health Ministry plans to augment the medical tourists to two million with tax-free health care zones specifically targeting the international patients.

According to Jatish N Sheth, director, Srushti Pharma and member Karnataka Drugs and Pharmaceutical Manufacturers Association, Indian companies find it difficult to enter the market primarily because the local companies are not in favour of imports. The organizing of CPhI in Turkey over the last couple of years is a case of point to showcase their expertise in drug manufacturing.

Reports from the Turkish Indian Chamber of Commerce and Industry (TICCI) says that , the pharmaceutical market became the sixth largest market in Europe and the 16th largest in the world in terms of sales in 2012. Pharmaceutical sales reached a stunning US$ 12.5 billion, which means a CAGR of nearly 10 percent between 2003 and 2012.

Domestic and international investors are ramping up their new investments in the pharmaceutical sector to take advantage of Turkey’s attractive market where the healthcare industry and the pharmaceutical sector grew by 5.8 per cent and 8.9 per cent respectively from 2012 to 2013, while the growth in real GDP was 3.5 percent for the same period.

Turkey has one of the largest and youngest labour pools in Europe with more than 65 per cent of the population aged between 24 and 54. The strength of Turkey’s labour force is reflected in the pharmaceutical sector. In the academic year 2011-2012, more than 41,000 students graduated from vocational training schools and universities in fields related to the pharmaceutical sector.

Transition in healthcare
The Turkish healthcare system has undergone the largest transition in its history. The success of health reform, HTP, has significantly improved the healthcare system and enhanced access to healthcare facilities. The Universal Health Insurance (UHI) program was put in place to provide healthcare to every individual. As a result, the Social Security Institution (SGK) has become the number one buyer on the purchasing side of healthcare services.

A rapidly growing young population is one of the key factors driving demand for the healthcare sector. Over the next two decades, as the current young population of Turkey ages, there is likely to be a sharp rise in healthcare demand as almost 80 per cent of a person’s healthcare requirements typically occur after the age of 40-50.

Turkey will experience a continued economic expansion and rising incomes which, in turn, will create more demand for health services and products. These increases are reflected in healthcare spending projections. According to Economist Intelligence Unit (EIU) forecasts, the healthcare sector in Turkey is set to boom by a CAGR of 5.6 per cent between 2013 and 2017, while most developed countries will be experiencing relatively lower growth rates. Turkey is also expected to surpass the forecast world average with this growth rate, noted a TICCI report.

The social security system now covers approximately 99 per cent of the total population with 75.2 million people covered, which is an increase of 29 per cent from 2002.

Investments in healthcare sector
Investments in the healthcare sector are expected to continue as the government strives to increase the number of hospital beds per 10,000 population to 32 in 2023, up from the current number of 26.5. The Turkish government has also taken on an ambitious healthcare PPP program.

The Ministry of Health is planning to open health ‘free zones’, which will include hospitals, rehabilitation centres, thermal tourism facilities, nursing houses, health techno-cities and R&D centres. These health "free zones" will be built in big cities where transportation will be relatively easy.

Turkey is the second most attractive market globally for public private partnership projects in the medium to long-term. Official targets to adopt and develop e-Health systems present significant investment opportunities for ICT infrastructure companies. There are plans to increase health tourism revenue to US$ 20 billion by 2023. As a result, healthcare spending per capita is estimated to almost triple by 2023, reaching US$ 2,000.