Access to current medicines in the treatment of Turkish melanoma patients

Abstract

Although the incidence of melanoma is increasing every year, the modern treatment modalities provided in recent years have led to significant gains in survival. However, there are difficulties in access to medicines in our country as well as in the world, especially due to the cost of medicines. In this study, we investigated to determine the access to drugs in our country. Our study was conducted using January 2025 data based on the Health Practice Circular of the Social Security Institution. In metastatic melanoma patients, BRAF/MEK inhibitor agents, vemurafenib-cobimetinib and dabrafenib-trametinib combination therapies, have been registered and reimbursed in the first-line treatment choice of the disease. Among immunotherapy drugs, ipilimumab and nivolumab as single agents have long been registered and reimbursed for the treatment of relapsed disease after chemotherapy, while pembrolizumab is still registered but not reimbursed. Ipilimumab-nivolumab is registered but still not imbursed. Talimogen laherparepvec and tebentafusp are still not registered. The dabrafenib-trametinib combination has been registered and reimbursed for the adjuvant treatment of stage 3. However, although both nivolumab and pembrolizumab are licensed as single agents, they are not covered by reimbursement. In the adjuvant treatment of stage 2 (2B/C) disease, pembrolizumab is licensed but not reimbursed, while nivolumab is not licensed. In conclusion, in our country, as in other parts of the world, there are difficulties and limitations in accessing the current treatment of melanoma. The significant survival benefits achieved with modern treatment of the disease are unfortunately hampered by difficulties in accessing treatment.