İlaç Neden Hep Gece İle Tan Aralığında

Ülkemizde ilaç bir türlü gün ışığına kavuşamadı; hep gece ile tan aralığında, başka bir deyişle Araf’ta kaldı. Ecz. Arif Yayla ilaç fiyatını belirleyen ana etkenleri Medikritik için yazdı

Ülkemizde ilaç bir türlü gün ışığına kavuşamadı; hep gece ile tan aralığında, başka bir deyişle Araf’ta kaldı. Bu kalışın detayını bir yana bırakıp, ilaç fiyat artışının nedenlerine kısaca değinelim.

ÜRETİMDEN TÜKETİME

1) Üretim - İthalat: İlaç, değer olarak ya ithaldir ya da çoklukla yabancı sermaye eline geçen üreticiler tarafından üretilir.
2) Dağıtım: Dağıtımda yani ecza depoculuğu konusunda dünyada en iyiler içinde sayılıyoruz. Bu başarıda çıtayı yükselten Ecza/Eczacı Kooperatiflerinin ön alması tartışılamaz.
2) Sunum: İlacın hastaya ulaşmasında da Türk Eczacıları, sıkıntılarına rağmen hastalarıyla barışık olabilme başarısını sağladı sağlamakta. Bu başarıda hocalarımızın hakkını ödeyemeyiz. Bize “Hastaya tepeden bakmayın” öğretisini iyi ki de dayatmışlar.

ÜRETİMDE SIKINTI:

1) ARGE - Yerli Üretim: Üretimde dışa bağımlılık her alanda olduğu gibi ilaç konusunda da birincil etmen. Küresel salgın sayesinde(!) aşı laboratuvarlarının neden kapatıldığını az çok sorguladık. Her nedense önce duvara toslamamız gerekiyor; şöyle ki: F-16 uçaklarının verilmemesi sonunda kendi savaş uçaklarımızı yapmaya yönelmemize ne kadar benziyor değil mi?

2) Ulusal İlaç Sektörüne Can Suyu: Bizim kuruluşlarımız desteksiz kalırsa emperyal devlerle boy ölçüşemez.

ECZANELER VE İLAÇ ZAMMI KONUSU

Türkiye’mizde, ilaç kadar disiplin altında olan başka bir zorunlu tüketim değeri yoktur. Bu durum olumludur. Ancak ilaç kıtlığı üretimdeki sıkıntıdan kaynaklansa da aşılamayacak bir sorun değildir. En önemli etken İlaç Fiyat Kararnamesinin güncel tutulmasıdır.
Fiyatlandırmadaki gecikmeler ya da yetersizlikler zincirleme olarak, tüm kademeleri sunumda ketum davranmaya iteliyor. Eczaneleri bu kademelerden ayrı tutuyorum. Çünkü elindeki ilacı saklama lüksü yok; çünkü YOK satarsa kaybedeceği hasta/müşterinin geri dönmeme riski yüksek.
Peki eczacı eczanesini ayakta tutabilmek için ne yapıyor? Bulabildiği kadar ilacı bolca almaya yöneliyor; çok aldığı ilaçların bir bölümü son kullanma tarihine takılıyor; gereksiz (tapon) ilaç eczane işletmesini zayıflatıyor. Sonuç; banka kredisine hücum!
Denebilir ki ilaç zam gelince eczacı “köşeyi dönüyor”. Buradaki ironiyi anlamakta zorlanabiliyoruz. Konuyu kısaca rakamlarla açıklamaya çalışalım:

1- Orta düzey bir eczanenin stoğunda tuttuğu ilaç iki aylık cirosu kadardır. Örneğimizde eczanenin cirosu 300 bin TL olsun. Bu 600 bin TL stok seviyesi demektir.
2- Cironun %20’si reçetesiz ilaç satışı ile ilaç dışı ürün satışı olsun. 300 bin TL’lik ciro içinde kamu payı %80 yani 300x80:100=240.000.- TL eder.
3- Kamu alacakları yaklaşık 3 ayda tahsil edilebiliyor. Bu şu demek: İlaca zam geldiğinde örnek eczanemizin 240x3=720.000.- TL kamu alacağı var demektir. Ortalama stok seviyesi 600.000.- TL idi. 720-600=120.000.- TL’ye düşen zam farkı açık ara güme gidiyor. Üstelik kamu alacağından elde edilen gelir payı göreceli olmaktan öteye gitmiyor.
4- Eczacının çıkmazı önlenebilir mi? En aza indirmenin yolları var: Kur ayarlamaları en fazla üç ayda bir yapılmalı; eczacı karı ortalama %30’lara çıkarılmalı; reçete hizmet bedeli kabul edilebilir bir seviyeye yükseltilmelidir.
Unutulmamalı, eczaneler yüz binin üstünde aileye ekmek parası sağlıyor.

Yorumlar

There are definitely a whole lot of details like that to take into consideration. That may be a nice level to convey up. I supply the ideas above as basic inspiration but clearly there are questions just like the one you bring up the place the most important factor will likely be working in sincere good faith. I don?t know if best practices have emerged around things like that, however I'm sure that your job is clearly identified as a good game. Each girls and boys feel the affect of just a moment抯 pleasure, for the rest of their lives.

A lot of thanks for your entire work on this blog. Kate take interest in going through internet research and it's easy to understand why. Many of us notice all about the lively medium you offer vital steps on this web site and in addition inspire response from people about this point while our own child has been being taught a great deal. Take advantage of the rest of the new year. You're the one performing a dazzling job.

I have to convey my love for your kindness in support of folks who have the need for help on this question. Your very own commitment to getting the message all through appears to be really powerful and have in most cases enabled individuals much like me to attain their pursuits. Your own interesting tutorial means a whole lot a person like me and additionally to my mates. Warm regards; from all of us.

I simply wished to thank you so much once again. I am not sure the things that I could possibly have accomplished without these points provided by you concerning such subject. It actually was an absolute horrifying issue in my circumstances, nevertheless witnessing your specialized style you dealt with the issue forced me to weep with delight. Now i am thankful for this advice and in addition have high hopes you find out what a powerful job you are always getting into educating the rest by way of your site. Most probably you haven't got to know all of us.

I simply needed to thank you so much once more. I'm not certain what I could possibly have undertaken without those secrets provided by you on that concern. Completely was a daunting scenario in my circumstances, however , noticing the expert fashion you managed it took me to jump over delight. I will be thankful for the information and as well , wish you know what an amazing job you were getting into instructing others with the aid of your web site. I know that you have never got to know any of us.

I definitely wanted to develop a remark to say thanks to you for all the fantastic tricks you are giving out at this website. My particularly long internet search has at the end been honored with extremely good tips to exchange with my companions. I 'd say that most of us readers are very much fortunate to be in a good community with very many perfect professionals with good plans. I feel truly grateful to have discovered your entire weblog and look forward to plenty of more exciting minutes reading here. Thank you once more for all the details.

I wanted to draft you the little observation in order to thank you so much once again considering the superb ideas you have shared in this article. This is really strangely open-handed with people like you to make easily all that a lot of people might have offered for sale as an ebook to help with making some money for their own end, even more so given that you might well have done it if you ever decided. The ideas as well served to provide a easy way to recognize that some people have a similar fervor just as my very own to see somewhat more concerning this condition. Certainly there are several more enjoyable opportunities ahead for individuals that see your site.

I want to convey my passion for your kindness giving support to people who need help on your content. Your personal commitment to getting the solution all through has been particularly helpful and has usually helped some individuals much like me to get to their dreams. Your own interesting information means so much a person like me and especially to my fellow workers. Regards; from everyone of us.

I'm also writing to make you understand what a incredible experience my friend's girl enjoyed going through yuor web blog. She mastered so many pieces, which include what it's like to possess an excellent giving nature to have other people quite simply learn several hard to do subject areas. You actually exceeded our expected results. I appreciate you for imparting the beneficial, trustworthy, educational as well as cool tips about that topic to Kate.

Thank you a lot for giving everyone a very breathtaking opportunity to read in detail from this web site. It really is very great plus packed with a good time for me personally and my office co-workers to search the blog at the least three times in a week to see the latest stuff you have got. Not to mention, I am just certainly happy with all the tremendous thoughts you give. Certain 3 tips on this page are completely the best we have all had.

I precisely desired to say thanks again. I am not sure the things I would've achieved without the entire thoughts contributed by you on my situation. Entirely was a very horrifying case in my opinion, nevertheless finding out the professional fashion you treated that made me to leap with happiness. Now i'm happy for this help and then sincerely hope you really know what an amazing job your are accomplishing educating many others using your websites. More than likely you have never encountered all of us.

I would like to get across my appreciation for your generosity in support of folks that really need help with this study. Your very own commitment to getting the solution up and down appeared to be definitely beneficial and have frequently enabled some individuals like me to get to their aims. Your entire informative tutorial entails so much to me and further more to my fellow workers. Thank you; from all of us.

I am glad for commenting to make you be aware of what a magnificent experience my cousin's girl went through using your blog. She came to find such a lot of pieces, not to mention what it's like to have an ideal helping heart to get the others just know chosen impossible subject areas. You actually exceeded people's expectations. Thank you for presenting the warm and helpful, trustworthy, revealing and also easy guidance on your topic to Ethel.

I want to express my thanks to you just for bailing me out of this type of setting. As a result of surfing through the the web and getting concepts which are not helpful, I figured my life was well over. Being alive without the strategies to the problems you have resolved by way of your guide is a critical case, and the ones which could have negatively affected my entire career if I hadn't encountered your site. Your actual know-how and kindness in taking care of a lot of things was very helpful. I'm not sure what I would've done if I had not encountered such a thing like this. I am able to at this moment look forward to my future. Thanks for your time so much for the skilled and results-oriented guide. I will not think twice to refer the website to any individual who will need care on this issue.

I am only commenting to make you understand of the magnificent experience our daughter developed checking yuor web blog. She mastered some details, which included how it is like to have a very effective coaching character to get certain people just know specified extremely tough subject matter. You truly surpassed readers' desires. Thanks for showing those productive, trustworthy, edifying and also easy guidance on the topic to Ethel.

A lot of thanks for each of your labor on this web site. My aunt enjoys conducting investigation and it is simple to grasp why. My spouse and i know all about the lively mode you convey practical solutions on this web site and as well as foster response from visitors on that concept then our favorite child is really understanding a whole lot. Have fun with the remaining portion of the year. Your conducting a powerful job.

I precisely needed to say thanks yet again. I do not know the things I might have taken care of without the entire smart ideas provided by you directly on this problem. It was actually the frightening condition for me personally, but spending time with this well-written avenue you treated it made me to jump over contentment. I'm just thankful for this support and as well , hope you realize what an amazing job you have been providing teaching most people with the aid of your webblog. More than likely you haven't encountered any of us.

Thank you a lot for providing individuals with an extraordinarily spectacular opportunity to discover important secrets from this web site. It's usually so pleasing plus jam-packed with a good time for me and my office co-workers to search your website at the least 3 times in 7 days to find out the latest issues you have. Of course, I am usually pleased with all the very good creative ideas you serve. Selected 4 areas in this posting are easily the most efficient we have all had.

I in addition to my friends were actually examining the nice ideas located on your web page and so all of the sudden got a terrible suspicion I had not thanked the web site owner for those techniques. All the guys happened to be totally warmed to read through them and have now in truth been taking pleasure in these things. Appreciation for being indeed helpful and for deciding upon this sort of decent areas most people are really desperate to discover. My very own honest regret for not expressing gratitude to sooner.

I have to show my thanks to the writer just for bailing me out of such a issue. After looking out through the world wide web and coming across opinions that were not powerful, I was thinking my life was gone. Being alive devoid of the approaches to the problems you've resolved by means of the website is a crucial case, as well as the kind which could have negatively damaged my entire career if I hadn't noticed the blog. Your actual ability and kindness in controlling the whole lot was tremendous. I am not sure what I would've done if I had not discovered such a thing like this. I can also at this time look ahead to my future. Thank you so much for this expert and results-oriented guide. I will not be reluctant to propose your blog to any individual who needs care on this topic.

I want to convey my love for your generosity giving support to folks who absolutely need guidance on this important issue. Your real dedication to passing the message all-around has been exceedingly productive and have regularly allowed somebody just like me to reach their dreams. Your personal valuable guideline denotes this much a person like me and substantially more to my office colleagues. Thanks a lot; from all of us.

I simply had to appreciate you again. I am not sure what I would've worked on without these recommendations revealed by you on this subject matter. This was the alarming problem in my position, however , noticing the very specialised style you dealt with that took me to jump for fulfillment. I'm thankful for this service as well as believe you really know what an amazing job you are carrying out training many others thru a blog. Probably you have never encountered any of us.

I together with my friends came checking the best items found on your web site and so all of a sudden got an awful suspicion I had not expressed respect to the web blog owner for those secrets. All of the boys appeared to be certainly happy to study them and have now sincerely been using them. Appreciate your getting considerably thoughtful as well as for picking out this sort of superb ideas millions of individuals are really needing to know about. My personal honest regret for not saying thanks to you sooner.

I'm just commenting to let you know what a terrific experience my wife's princess gained going through your web page. She came to find a wide variety of details, most notably what it is like to possess a very effective helping nature to have many others quite simply completely grasp specific grueling issues. You really surpassed my desires. Thank you for giving such important, trusted, revealing and also cool tips about the topic to Sandra.

I precisely desired to say thanks all over again. I'm not certain the things I might have used in the absence of the secrets documented by you directly on that question. Certainly was a fearsome crisis in my position, nevertheless coming across the specialised form you resolved it took me to leap with joy. Now i'm thankful for the help as well as hope you realize what an amazing job you are putting in instructing most people by way of your website. I'm certain you have never met any of us.

I simply needed to thank you so much all over again. I am not sure what I could possibly have implemented without the type of strategies documented by you over that subject. It was a real alarming condition in my view, but discovering this well-written mode you treated that took me to cry over gladness. I'm just grateful for this guidance and even hope that you realize what a great job you have been doing instructing the mediocre ones thru your blog post. More than likely you've never encountered any of us.

My spouse and i have been absolutely joyful that John could do his reports from the precious recommendations he discovered from your web pages. It's not at all simplistic just to choose to be handing out strategies some people have been trying to sell. And we also fully grasp we have got the website owner to be grateful to for that. The specific illustrations you have made, the simple site menu, the relationships your site help instill - it is most wonderful, and it is letting our son in addition to the family consider that the situation is cool, which is certainly quite essential. Many thanks for all!

I in addition to my pals appeared to be digesting the great points from your web site and then all of the sudden came up with a terrible feeling I never thanked the website owner for those strategies. All of the people are actually totally very interested to study them and have extremely been taking pleasure in these things. Appreciate your indeed being simply considerate and then for getting this form of fine guides millions of individuals are really needing to learn about. Our own sincere apologies for not expressing gratitude to sooner.

Thank you so much for providing individuals with remarkably breathtaking possiblity to check tips from this blog. It is always very cool and also packed with a great time for me personally and my office fellow workers to visit your web site particularly thrice every week to read the latest things you have. Of course, I am also certainly impressed with your spectacular tactics you serve. Selected two tips in this post are basically the best I have had.

I wish to express thanks to the writer just for bailing me out of this type of predicament. After researching throughout the world wide web and meeting proposals which are not pleasant, I figured my entire life was well over. Being alive without the presence of approaches to the difficulties you've solved through your entire guideline is a crucial case, and those which might have adversely damaged my career if I had not discovered your site. Your good ability and kindness in dealing with the whole thing was crucial. I'm not sure what I would have done if I hadn't come upon such a stuff like this. I am able to at this moment look forward to my future. Thanks a lot very much for your skilled and sensible help. I will not hesitate to endorse your web page to anybody who should receive tips on this issue.

Thank you for every one of your work on this site. Kate takes pleasure in conducting internet research and it's easy to see why. Most people learn all relating to the lively means you produce worthwhile tips and hints through your blog and in addition attract response from some other people on that area of interest plus our favorite princess is discovering a whole lot. Take pleasure in the rest of the year. You're doing a superb job.

Thanks so much for giving everyone remarkably brilliant opportunity to read critical reviews from this site. It really is so superb and as well , packed with a lot of fun for me personally and my office mates to search your blog the equivalent of thrice in 7 days to read the new items you will have. Of course, we're certainly happy for the incredible tips and hints served by you. Certain 2 tips in this post are rather the most effective we've ever had.

I really wanted to jot down a brief message to be able to say thanks to you for these fabulous tips and hints you are giving at this site. My incredibly long internet search has at the end been recognized with extremely good facts and strategies to talk about with my contacts. I would point out that many of us website visitors actually are unequivocally endowed to exist in a good network with very many marvellous individuals with insightful techniques. I feel extremely fortunate to have used your web pages and look forward to so many more cool minutes reading here. Thank you once again for everything.

I must point out my affection for your kindness in support of all those that should have help on this one area of interest. Your personal commitment to passing the solution along appeared to be extremely good and has continually empowered associates much like me to attain their aims. Your personal useful guide indicates a great deal to me and extremely more to my mates. Thanks a lot; from each one of us.

Thanks for all of your efforts on this site. My niece delights in doing internet research and it is easy to see why. A number of us hear all concerning the compelling manner you deliver helpful guidance through the web blog and as well foster response from website visitors on that matter so our own simple princess has been discovering a whole lot. Have fun with the remaining portion of the year. You are conducting a stunning job.

I have to get across my appreciation for your kind-heartedness supporting people that really want help on this one situation. Your very own dedication to passing the message up and down came to be pretty important and has continually helped employees much like me to achieve their dreams. Your new invaluable instruction means a whole lot a person like me and a whole lot more to my colleagues. With thanks; from each one of us.

I as well as my friends were checking out the excellent tricks found on your web blog then instantly I had a horrible suspicion I had not expressed respect to you for those strategies. The boys were definitely stimulated to see all of them and already have really been taking pleasure in those things. Many thanks for simply being quite accommodating as well as for figuring out variety of terrific themes most people are really needing to learn about. My personal sincere apologies for not expressing gratitude to earlier.

Thanks for all of your labor on this web page. Betty really likes getting into internet research and it is easy to see why. All of us learn all of the compelling mode you provide efficient steps by means of your web site and even boost response from visitors on this area of interest and my child is certainly studying a lot of things. Have fun with the rest of the year. You are doing a tremendous job.

Thank you a lot for providing individuals with an extraordinarily splendid possiblity to read articles and blog posts from here. It's always very fantastic and packed with a lot of fun for me personally and my office mates to visit your site no less than thrice every week to see the latest stuff you will have. And indeed, I'm just always contented for the splendid tricks served by you. Selected 2 ideas in this post are honestly the most suitable I've had.

Yeni yorum ekle

Bu alanın içeriği gizlenecek, genel görünümde yer almayacaktır.

Plain text

  • Hiç bir HTML etiketine izin verilmez
  • Web sayfası adresleri ve e-posta adresleri otomatik olarak bağlantılara dönüşür.
  • Satır ve paragraflar otomatik olarak bölünür.