Medical oncologists' dance with international guidelines and national reimbursement: insights from a survey in Türkiye.

Abstract

Background: This study explores Turkish medical oncologists' perceptions of integrating international treatment guidelines with national reimbursement policies, considering local legal, economic, and healthcare constraints.

Research design and methods: A cross-sectional online survey was conducted from March 24-31, 2024, targeting all 1,096 active oncologists registered with the Turkish Medical Oncology Association, as these specialists are exclusively authorized to prescribe anticancer drugs under national regulations. The survey included 25 questions on demographics, perceptions of guidelines, and integration preferences. Statistical analyses, including chi-square tests and logistic regression, identified factors influencing guideline preferences.

Results: Among 337 respondents (31%), 94% found international guidelines essential, but 62% noted a lack of clear real-world algorithms. Significant predictors for preferring national guidelines included working in public institutions (OR: 3.90, p < 0.001), concerns about pharmaceutical industry influence (OR: 4.38, p = 0.017), legal challenges (OR: 5.89, p < 0.001), and variability among clinical research centers (OR: 2.95, p = 0.019). Despite these challenges, 57% favored national guidelines for their compatibility with local healthcare policies.

Conclusions: The findings highlight the need for hybrid models that merge the evidence-based rigor of international frameworks with local healthcare priorities. Such models can enhance equitable and effective cancer care in Türkiye by addressing both global standards and national realities.