Türkiye Manufactures Medicines But Who Develops the Molecules
Domestic production import dependence and next generation therapies
Behlül Ünver | President, World Health Tourism Platform
When a patient leaves the consulting room, much of their treatment often continues at home rather than in hospital. A tablet that regulates blood pressure, insulin that controls diabetes, an antibiotic prescribed for an infection, a biological product used in cancer treatment, or medication taken for years for a chronic condition... Medicines carry much of the health system's less visible workload.
This is why discussing medicines solely in terms of prices, exchange rates or the number of packs is inadequate. Medicines are simultaneously a matter of public health, industrial policy, scientific research, security of supply and public expenditure. The central question for Türkiye is not simply how many packs it manufactures, but how far it can develop the active ingredients, manufacturing know-how and intellectual property behind them.
A large market whose figures need careful interpretation
According to the Preliminary Pharmaceutical Sector Inquiry Report published in 2026, the sales value of Türkiye's pharmaceutical market reached TRY 479 billion in 2025. Of this, TRY 417 billion was generated through pharmacies and TRY 61 billion through hospitals. In other words, approximately 87% of market value comes from the pharmacy channel. This percentage does not directly represent the number of outpatients, but it clearly illustrates the central role medicines play in treatment beyond hospital walls.
The same report ranked Türkiye 19th worldwide in 2024, with a pharmaceutical market worth USD 11.5 billion. Market size matters, but in an economy with high inflation, growth expressed in lira cannot be treated as a sufficient measure of success. What matters is whether patients receive the medicines they need on time, whether public resources are used appropriately, and how much technology the country develops through this market.
What manufacturing medicines in Türkiye actually tells us
In 2025, 89.98% of the medicines sold, measured by packs, were manufactured in Türkiye. Finished products manufactured in Türkiye accounted for 59.59% of sales value, while imported finished products accounted for 40.41%. These figures demonstrate the strength of Türkiye's pharmaceutical manufacturing infrastructure. However, percentages describing the place of manufacture do not establish that a product's active ingredient or molecule is domestically developed or produced.
We must distinguish at least four separate levels: a medicine whose finished product is manufactured in Türkiye; one whose active ingredient is produced in Türkiye; one whose molecule is developed in Türkiye; and one whose patent and manufacturing know-how belong to Türkiye. Current publicly available statistics mainly describe the first level. Equally clear, comprehensive data are not available on active ingredient origin, the number of domestically developed molecules, intellectual property ownership or the value added retained in Türkiye.
Sales value does not identify a domestically developed molecule
We mislead ourselves if we measure domestic capability solely by a factory's address or a product's sales value. Sales value is affected by pricing, exchange rates, patent protection, reimbursement coverage and therapeutic area, among many other factors. High revenue does not necessarily mean substantial domestic technology, just as low revenue does not imply low scientific value. Genuine domestic capability extends across the value chain, from a research idea and molecule discovery to active ingredient production, clinical research, regulatory submissions, commercial manufacturing and exports.
Dependence on imported active ingredients and critical inputs varies by product group and production stage. The problem is the absence of a transparent dataset covering the sector as a whole. Where is each medicine's active ingredient produced? Who owns the molecule's patent? How many suppliers provide a critical input? For which products does the public sector depend on a single country, and how much sales revenue remains in Türkiye? Pharmaceutical policy should rest on an inventory that answers these questions and is updated by product and stage of the value chain.
Such an inventory is essential for health security as well as economic planning. During a pandemic, war, trade restriction or logistics crisis, having a factory capable of making the finished product is not enough. If the active ingredient or a critical auxiliary material does not arrive, the production line cannot operate.
The world is moving beyond tablets towards cell and gene therapies
The global pharmaceutical industry no longer grows solely through conventional chemical molecules. Biological and biosimilar medicines, mRNA technologies, targeted therapies, personalised medicine, gene therapies, somatic cell therapies and tissue-engineered products are changing healthcare. The European Medicines Agency places gene, cell and tissue-engineering-based advanced therapies within a distinct regulatory category.
Biotechnology medicines are also becoming more significant in Türkiye. According to the Türkiye Biopharmaceutical Platform, these products reached TRY 60.9 billion in 2024, representing 18.8% of the total market. Nevertheless, the scope of domestic biosimilar production remains limited. If we do not want to remain merely an importing market for next generation treatments, we must build laboratories, clinical research capabilities, bioreactor capacity, data infrastructure and a skilled workforce now.
The journey from a drug candidate to an approved medicine can take an average of 10 to 15 years. Approximately USD 201.3 billion was spent on pharmaceutical R&D worldwide in 2025. The estimate for Türkiye in the same report is around USD 540 million. Although calculation methods may differ between sources, the difference in scale is clear: Türkiye needs an ecosystem that can finance sustained research, as well as manufacturing facilities.
New treatments also influence health tourism
A new molecule, an original formulation or a particular treatment protocol is more than a scientific publication or an industrial product; it can also affect international demand for a country's healthcare services. Patients, particularly those with diseases such as cancer where time and treatment options are critical, may travel abroad to access treatments that are not authorised, reimbursed or provided in their own country, or are available only at selected centres. The European Union's guidance on planned cross-border care explicitly recognises that patients may seek treatment in another country because an intervention is unavailable at home or waiting times are long.
Competition in health tourism therefore involves more than hospital buildings, attractive prices and physician promotion. Targeted cancer medicines, immunotherapies, cellular therapies, radiopharmaceuticals, personalised treatment approaches, clinical trials and molecular tumour boards can directly influence a patient's choice of country. Generating scientific evidence for a molecule, formulation or treatment approach developed in Türkiye, securing intellectual property and the relevant regulatory approvals, and providing it in qualified centres can benefit patients while supporting high-value health tourism.
However, turning a patient's hope into a commercial promise poses a serious risk, particularly in oncology. Experimental interventions must be clearly distinguished from authorised treatments. The evidence, eligible patient groups, alternatives, costs, potential adverse effects and follow-up arrangements should be explained in the patient's own language. Success in health tourism should be measured by the ability to translate scientific innovation into safe, ethical and traceable care, not simply by announcing a new treatment.
Universities must contribute to development rather than observe it
We cannot leave drug development solely to pharmaceutical companies' investment decisions. Companies are indispensable for manufacturing, scaling and market access, but commercial expectations alone should not determine which molecules and critical therapeutic areas the country prioritises. The public sector, universities, clinicians, pharmacists, engineers and industry should establish a shared research agenda.
Faculties of pharmacy should be central to this structure. Medicinal chemistry can contribute to molecular design; pharmaceutical technology to formulation and manufacturing methods; pharmacognosy to the scientific assessment of plant-derived resources; pharmacology and toxicology to safety studies; and clinical pharmacy to appropriate use, drug interactions and the monitoring of treatment outcomes. This expertise should produce patents, regulatory dossiers, pilot manufacturing, clinical research and public policy, as well as publications.
Instead of each university attempting to build expensive infrastructure independently, shared research centres and pilot facilities compliant with good manufacturing practice could be established. Academic promotion criteria should recognise developed molecules, patents, licences, clinical protocols, technology transfer and public health problems addressed, alongside publication counts.
University-industry collaboration should extend beyond providing laboratory services to companies. Research initiated to address public priorities should define data rights, intellectual property, pricing and access conditions from the outset. It must be clear how a publicly funded product will benefit society.
Pharmaceutical policy is also outpatient care policy
Much chronic disease care in Türkiye is delivered on an outpatient basis. Medicines sustain treatment for hypertension, diabetes, asthma, heart disease and many mental health conditions. Access to the right medicine is therefore more than a pharmaceutical or industrial policy issue; it is an element of healthcare that directly affects hospital admissions, emergency department visits, lost working time and quality of life.
Medicine shortages interrupt treatment, while inappropriate or unnecessary use harms both patients and budgets. These are distinct problems. Making essential medicines harder to obtain in the name of savings is not rational use. Rational use means patients receive medicines appropriate to their clinical needs, at the right dose, for the right duration and at the most appropriate attainable cost.
Unnecessary medicine use is not solely a patient choice
The World Health Organization has long emphasised that more than half of medicines worldwide are prescribed, dispensed or sold inappropriately, and that approximately half of patients do not take them correctly. Major problems include polypharmacy, antibiotic use for non-bacterial illnesses, prescribing that departs from clinical guidelines, use of prescription medicines without medical supervision and non-adherence to treatment.
In Türkiye, the solution requires more than calls for greater public awareness. Physicians need an up-to-date medication list for each patient. Digital systems should flag duplicate prescriptions containing the same active ingredient, older patients should undergo regular medication reviews, and pharmacist counselling should become part of treatment. Diagnosis-based feedback on antibiotic prescribing, hospital antimicrobial stewardship programmes and comparative reports showing physicians their prescribing patterns should be implemented.
We should measure more than the number of packs consumed. Treatment adherence, preventable drug interactions, unnecessary antibiotic use, duplicate prescriptions, treatment interruptions and medicine-related hospital visits should also be monitored. Data should support feedback that improves clinical quality, rather than serve as an instrument of punishment.
Products marketed as medicines without being medicines
Any discussion of the pharmaceutical market must also consider food supplements, vitamin and mineral products, herbal mixtures and similar products sold online. It would be wrong to treat them all alike. Supportive products may have a role in correcting a deficiency identified by a physician or in other appropriate circumstances. However, blurring the distinction between a supplement and an authorised medicine is a serious health concern for consumers.
Food supplements are not medicines. Under the applicable regulations, their labelling, presentation and advertising cannot claim to prevent, treat or cure disease. Nevertheless, social media posts, personal testimonials, promotional imagery suggesting medical endorsement and the assumption that natural means harmless can position some products as though they were medicines.
The risks extend beyond unnecessary spending. They may include uncertain composition, incorrect dosing, interactions with medicines, liver or kidney damage, delays in receiving effective treatment and unsupervised use, particularly by people with chronic conditions. The word natural is not a safety certificate, and approval does not mean that therapeutic efficacy has been demonstrated to the standard required for medicines.
The solution is a single verification system that clearly distinguishes authorised medicines, traditional herbal medicinal products, food supplements and cosmetics. A QR code on the product should reveal the type of authorisation or approval, manufacturer, permitted claims and warnings. Health claims in digital advertising should be monitored regularly, sales platforms should take responsibility, suspected adverse effects should be reportable, and pharmacists' advisory role should be strengthened.
What Türkiye should do to develop domestic medicines
First, we should redefine domestic capability. A product packaged in Türkiye should not be placed in the same category as one whose active ingredient, technology and intellectual property have been developed domestically. Incentives should measure the stages at which domestic value is added.
Second, we should identify critical products instead of trying to localise every medicine simultaneously. Priorities should include active ingredients dependent on a single supplier, essential medicines, products needed during epidemics and biological treatments with a substantial budget impact.
Third, public procurement and reimbursement policies should consider security of supply, domestic R&D, technology transfer and export capacity, rather than the lowest price alone. Protection should not be indefinite or unconditional; it should be assessed against manufacturing, quality, investment and export targets.
Fourth, universities, and particularly faculties of pharmacy, should be core participants in pharmaceutical policy. Shared research centres, pilot manufacturing infrastructure, efficient contracting and ethics review processes should be established so that academic knowledge can move from molecular research into clinical practice. Collaboration with companies is necessary, but research agendas must not be confined to their commercial priorities.
Fifth, pricing should become more predictable. Sustainable manufacturing matters as much as medicine affordability. A pricing system disconnected from raw material, energy, labour and technology costs can lead to product withdrawals, supply shortages and postponed investment.
Sixth, active ingredient and biotechnology manufacturing need long-term financing. Developing molecules requires patience over a decade. Incentives should be sustained and tied to milestones rather than annual budget cycles. Unsuccessful research must also be recognised as part of scientific learning.
Finally, rational medicine use should not be positioned against domestic production policy. Türkiye grows stronger by developing appropriate medicines and delivering them to the right patients, not by consuming more unnecessary medicines. Domestic industry's objective should be better health outcomes and greater value added, rather than more packs sold.
The issue goes beyond the number of packs we manufacture
Türkiye is not starting from scratch in pharmaceutical manufacturing. It has strong facilities, a skilled workforce, a large market, universities and substantial production experience. It now needs to deepen this capacity through molecule development, active ingredients, biotechnology, clinical research and exports. We should therefore monitor the scientific knowledge generated and the value added retained in Türkiye, rather than sales figures alone.
Pharmaceutical independence does not mean manufacturing every product domestically; that is neither realistic nor necessary. It means understanding the risks we face when a critical treatment is needed, managing alternative sources of supply, and possessing the scientific and industrial capabilities to develop strategic products.
A country's pharmaceutical strength is measured not by the number of packs on its shelves, but by its ability to research the molecules it needs, manufacture them safely and deliver them to patients without interruption.
Key indicators
Indicator | Latest value |
Türkiye pharmaceutical market sales value | TRY 479 billion 2025 |
Pharmacy channel share of market value | Approximately 87% 2025 |
Pack share of finished products manufactured in Türkiye | 89.98% 2025 |
Value share of finished products manufactured in Türkiye | 59.59% 2025 |
Biotechnology medicine share of the Türkiye market | 18.8% 2024 |
Global pharmaceutical R&D expenditure | USD 201.3 billion 2025 |
Sector-wide share by active ingredient origin | No comprehensive public data |
Market share of original molecules developed in Türkiye | No comprehensive public data |
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