Amendments to the Health Implementation Communiqué
Through the Communiqué on Amendments to the Social Security Institution Health Implementation Communiqué (the Communiqué), published in the Official Gazette dated May 23, 2026, and numbered 33262, significant amendments have been introduced to the Social Security Institution Health Implementation Communiqué (SUT). These amendments concern, inter alia, reimbursement criteria for various medicinal product groups, health committee report procedures, prescribing conditions, and patient co-payment practices. The Communiqué mainly covers regulations relating to rheumatological diseases, prostate cancer, the treatment of anemia associated with chronic kidney disease, procedures for receiving treatment abroad, and the inclusion of certain medicines in the list of drugs exempt from patient co-payments.
The principal amendments - without constituting an exhaustive list- are summarized below:
- The criteria for the use of the medicinal product containing the active ingredient certolizumab, used in the treatment of psoriatic arthritis, ankylosing spondylitis and non-radiographic axial spondyloarthritis, have been re-regulated. Certain previously required conditions regarding the use of anti-TNF medicines and lack of response thereto have been abolished, thereby changing the conditions for access to treatment.
- The health board report criteria regarding biological medicines used in rheumatologic diseases have been updated. The reporting and continuation of treatment procedures to be applied in cases of insufficient response to treatment, occurrence of side effects or change of medicine have been re-regulated.
- The reimbursement conditions were expanded to cover the use of the apalutamide-based medicinal product, which is used in the treatment of metastatic hormone-sensitive prostate cancer, in combination with androgen deprivation therapy.
- The principles regarding the use of the medicinal product containing the active ingredient daprodustat, used in the treatment of anemia related to chronic kidney disease, have been re-determined. Detailed regulations regarding hemoglobin values, dose increase, treatment continuation criteria and specialist physician evaluations have been introduced.
- Pulmonary mycobacterial infection, cutaneous mycobacterial infection and unspecified mycobacterial infection have been added to the list of infectious diseases considered within the scope of “Procedures for Overseas Treatment Due to Life-Threatening Diseases and Special Conditions”.
- Amendments have been made to prescribing rules for outpatient treatment. The cost of the medicinal product containing fosfomycin will be reimbursed by the Institution only for the treatment of uncomplicated cystitis and for periprocedural antibiotic prophylaxis during transrectal prostate biopsy in adult men, limited to a maximum of one package.
- Through the amendment made within the scope of the “List of Medicines Exempt from Patient Contribution Fees”, the ICD code “A31” has been added after the expression “A15-A19”. Accordingly, medicines used for certain types of mycobacterial infections have been included within the scope of medicines exempt from patient contribution fees.
- Amendments have been made to the “List of Medicines to Be Reimbursed” (Annex-4/A). In this context, the reimbursement conditions and principles of use for a large number of medicines have been updated.
- Provisions requiring that certain medicines be prescribed only by physicians from the relevant medical specialties, and that health committee reports be obtained for specific treatment methods, have also been updated.
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