A conceptual image representing the balance between populism and neoliberalism in healthcare policy.

Turkey's Balancing Act: How Populism and Neoliberalism Shape Healthcare Policy

Jordan Keane in Health & Wellness November 2025 • 4 min read.

"An in-depth look at how Turkey navigates the complexities of pharmaceutical policy, balancing economic reforms with the needs of its citizens."

In September 2009, Turkey initiated a significant overhaul of its pharmaceutical expenditure and pricing strategies. By introducing a global budget, the nation saved approximately 20 billion TL in public pharmaceutical expenditure between 2010 and 2012. A significant portion of these savings came from implementing stricter price controls, which reduced the profit margins of pharmaceutical producers and distributors.

This approach favored what might be termed a 'populist' solution, contrasting with neoliberal alternatives such as increasing out-of-pocket payments for medicines. This decision presents a puzzle, given the Justice and Development Party (AKP) government's inclination towards lenient and business-friendly regulations.

This article delves into the policy reform, examining it through the lens of several factors: the AKP's need to maintain electoral support by ensuring access to public health services, the lack of strong business lobbies advocating for high medicine prices, and the absence of a robust industrial policy strategy for the pharmaceutical sector. This case study provides valuable insights into Turkish politics, suggesting that the AKP's economic and social policies are influenced by its core constituencies—lower-class voters and "Anatolian capital"—as well as internal policy factions consisting of neoliberal technocrats and election-focused party leaders.

What Drives Turkey's Pharmaceutical Policy?

A conceptual image representing the balance between populism and neoliberalism in healthcare policy.

Several factors influenced Turkey's unique policy decisions regarding pharmaceutical expenditure and pricing. These factors highlight a blend of economic considerations, political motivations, and social priorities that define the nation's approach to healthcare.

The AKP government's policy decisions were shaped by a combination of factors:

Electoral Interests: Maintaining access to public health services is critical for the AKP to retain voter support, particularly among its lower-income base.
Limited Lobbying Power: The absence of strong business interests pushing for high medicine prices allowed the government to implement stricter controls.
Lack of Industrial Policy: A missing developmentalist strategy for the pharmaceutical sector meant there was no incentive to keep prices high to stimulate local industry growth.

Ultimately, Turkey's pharmaceutical policy reflects a balance between fiscal discipline and the need to maintain public support, illustrating the complex interplay of populism and neoliberalism in shaping government actions.

Navigating the Future of Turkish Healthcare

About this Article -

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Everything You Need To Know

What specific measures did Turkey implement in 2009 to overhaul its pharmaceutical expenditure and pricing strategies?

In September 2009, Turkey introduced a global budget and stricter price controls. The implementation of the global budget helped the nation save approximately 20 billion TL in public pharmaceutical expenditure between 2010 and 2012. The savings were largely achieved by reducing the profit margins of pharmaceutical producers and distributors through stricter price controls, a move that was part of the government's strategy to balance economic reforms with the need to maintain access to public health services for its citizens.

How did the Justice and Development Party (AKP) government's approach to pharmaceutical policies in Turkey reflect both populist and neoliberal influences?

The AKP government's pharmaceutical policies demonstrate a balancing act between populism and neoliberalism. The introduction of a global budget and stricter price controls, which reduced the profit margins of pharmaceutical companies, can be viewed as a 'populist' measure, as it prioritized ensuring access to affordable medicines for the public. This contrasts with neoliberal approaches, such as increasing out-of-pocket payments. The AKP's actions were also influenced by factors such as electoral interests, the lack of strong business lobbies advocating for high medicine prices, and the absence of a robust industrial policy strategy for the pharmaceutical sector.

What were the primary drivers behind the AKP government's decisions regarding pharmaceutical policy in Turkey?

Several factors shaped the AKP government's pharmaceutical policy. Electoral interests were a key driver, as maintaining access to public health services was crucial for retaining voter support, especially among lower-income groups. The absence of strong business lobbies pushing for high medicine prices also allowed the government to implement stricter controls. The lack of a comprehensive industrial policy strategy for the pharmaceutical sector meant there was less incentive to keep prices high to stimulate local industry growth, allowing the government to focus on cost-saving measures.

How did the absence of strong business lobbies influence Turkey's pharmaceutical policies?

The absence of strong business lobbies advocating for high medicine prices significantly impacted Turkey's pharmaceutical policies. This lack of influence allowed the AKP government to implement stricter price controls and cost-saving measures. The absence of powerful industry advocates removed a significant obstacle, enabling the government to prioritize its electoral interests and the need to provide affordable healthcare to the public. This situation contrasts with scenarios where powerful lobbying groups can influence policy in favor of higher prices and increased profits.

What are the broader implications of Turkey's approach to pharmaceutical policy for other rapidly developing economies?

Turkey's experience offers crucial insights into the complexities of health policy in rapidly developing economies. The balancing act between economic reform and social welfare, shaped by political priorities and interest groups, demonstrates the challenges in creating sustainable and equitable healthcare systems. Other developing nations can learn from Turkey's experience by understanding the interplay of populism and neoliberalism. They can also study how electoral interests, the influence of business lobbies, and industrial policy strategies shape pharmaceutical policies and their implications for public health outcomes. This includes the need to balance fiscal discipline with public support, and the importance of considering various stakeholders in health policy decision-making.