§ 02 — Comparison

Compare regulatory pathways side-by-side

Benchmark MAHMAH, GMPGMP, HTAHTA and pathway requirements across up to three markets.

Country A

Country B

Country C

Highlight differences

Criterion	🇹🇷Turkey	🇺🇸United States
Authority & dossier
Regulatory authority	TİTCK	FDA
English submissions	No	Yes
CTD accepted	Yes	Yes
eCTD accepted	Yes	Yes
Reliance pathway	None	None
Reference agencies	—	—
Lead pathway (timeline & fees) — Ruhsat Başvurusu (Marketing Authorisation Application) · New Drug Application — 505(b)(1)
Pathway name	Ruhsat Başvurusu (Marketing Authorisation Application)	New Drug Application — 505(b)(1)
Approval timeline	210–540 days	304–365 days
Application fee	TRY 250,000	USD 4,310,002
Annual renewal	TRY 50,000	USD 416,734
Local representative	Required	Not required
Local manufacturing	Not required	Not required
GMP inspection	Required	Required
MAH & local presence
Local entity required	Yes	No
Local responsible person	Yes	Yes
RP role	A Turkish-resident Pharmacist (Sorumlu Müdür) registered with the Turkish Pharmacists Association (TEB) is mandatory for the importer/wholesaler licence. A separate Pharmacovigilance Officer (Farmakovijilans Sorumlusu) is required and must report to the Turkish Pharmacovigilance Centre (TÜFAM).	US Agent: a person residing or maintaining a place of business in the US, designated to act on behalf of the foreign establishment for FDA communications, including notification of inspections.
Accelerated pathways
Designations available	4 designations	6 designations
Examples	Priority Review, Orphan Drug Pathway (Yetim İlaç), Conditional Approval (Şartlı Ruhsat) +1	Priority Review, Breakthrough Therapy Designation, Accelerated Approval — Subpart H/E +3
Post-approval lifecycle
Variations framework	Post-approval variations classified into Type IA, IB, II, and Notification, aligned with EU Commission Regulation 1234/2008. TİTCK Variations Guideline (2017, updated) implements EU framework.	FDA classifies post-approval changes as: Annual Reportable, Changes Being Effected (CBE-0 immediate, CBE-30 with 30-day pre-implementation notice), and Prior Approval Supplements (PAS) — the most significant changes requiring FDA approval before implementation. Major manufacturing or labelling changes typically require a PAS.
Renewal cycle	Marketing authorisations valid for 5 years; renewal required 9 months before expiry. After first renewal, MA is granted for indefinite period (aligned with EU practice) unless safety concerns require subsequent renewal.	FDA does not require periodic renewal of NDAs or BLAs — approvals remain in effect indefinitely subject to compliance, payment of annual program fees, and post-marketing requirements. Annual reports are required.
Pharmacovigilance	Turkish Pharmacovigilance Centre (TÜFAM, Türkiye Farmakovijilans Merkezi) under TİTCK. PSURs aligned with ICH E2C(R2). Mandatory ICSR reporting via TÜFAM electronic system. Turkey is a WHO-UMC member.	Mandatory expedited reporting of serious unexpected ADRs within 15 calendar days; periodic safety reports (PADERs/PAERs) for the first 3 years post-approval, then annually. PSURs in ICH E2C(R2) format accepted in lieu of PADERs by agreement. FAERS database receives spontaneous reports. Post-Marketing Requirements (PMRs) and Commitments (PMCs) tracked publicly.
Unlicensed access
Named Patient Supply	Available	Available
Compassionate Use	Available	Available
Emergency Import	Available	Available
Parallel Import	Not permitted	Not permitted
Clinical trials
CTA approval	Required	Required
Ethics approval	Yes	Yes
CTA timeline	60–90 days	30–30 days
GCP standard	ICH-GCP + Turkish GCP Guidelines (2008, updated)	ICH E6(R3) (adopted via FDA guidance January 2025); 21 CFR 312, 314, 50, 56
Pricing & reimbursement
Price regulation	Regulated	Free pricing
Reference pricing	Yes	No
HTA required	Yes	No
HTA body	Sağlık Hizmetleri Genel Müdürlüğü (Ministry of Health HTA Department) + SGK reimbursement evaluation	ICER (Institute for Clinical and Economic Review) — independent, non-binding

Verdict colours indicate lower, moderate, or higher regulatory burden — they're not value judgements on a market.

Authority & dossier

Regulatory authority

TurkeyTİTCK
United StatesFDA

English submissions

TurkeyNo
United StatesYes

CTD accepted

TurkeyYes
United StatesYes

eCTD accepted

TurkeyYes
United StatesYes

Reliance pathway

TurkeyNone
United StatesNone

Reference agencies

Turkey—
United States—

Lead pathway (timeline & fees) — Ruhsat Başvurusu (Marketing Authorisation Application) · New Drug Application — 505(b)(1)

Pathway name

TurkeyRuhsat Başvurusu (Marketing Authorisation Application)
United StatesNew Drug Application — 505(b)(1)

Approval timeline

Turkey210–540 days
United States304–365 days

Application fee

TurkeyTRY 250,000
United StatesUSD 4,310,002

Annual renewal

TurkeyTRY 50,000
United StatesUSD 416,734

Local representative

TurkeyRequired
United StatesNot required

Local manufacturing

TurkeyNot required
United StatesNot required

GMP inspection

TurkeyRequired
United StatesRequired

MAH & local presence

Local entity required

TurkeyYes
United StatesNo

Local responsible person

TurkeyYes
United StatesYes

RP role

TurkeyA Turkish-resident Pharmacist (Sorumlu Müdür) registered with the Turkish Pharmacists Association (TEB) is mandatory for the importer/wholesaler licence. A separate Pharmacovigilance Officer (Farmakovijilans Sorumlusu) is required and must report to the Turkish Pharmacovigilance Centre (TÜFAM).
United StatesUS Agent: a person residing or maintaining a place of business in the US, designated to act on behalf of the foreign establishment for FDA communications, including notification of inspections.

Accelerated pathways

Designations available

Turkey4 designations
United States6 designations

Examples

TurkeyPriority Review, Orphan Drug Pathway (Yetim İlaç), Conditional Approval (Şartlı Ruhsat) +1
United StatesPriority Review, Breakthrough Therapy Designation, Accelerated Approval — Subpart H/E +3

Post-approval lifecycle

Variations framework

TurkeyPost-approval variations classified into Type IA, IB, II, and Notification, aligned with EU Commission Regulation 1234/2008. TİTCK Variations Guideline (2017, updated) implements EU framework.
United StatesFDA classifies post-approval changes as: Annual Reportable, Changes Being Effected (CBE-0 immediate, CBE-30 with 30-day pre-implementation notice), and Prior Approval Supplements (PAS) — the most significant changes requiring FDA approval before implementation. Major manufacturing or labelling changes typically require a PAS.

Renewal cycle

TurkeyMarketing authorisations valid for 5 years; renewal required 9 months before expiry. After first renewal, MA is granted for indefinite period (aligned with EU practice) unless safety concerns require subsequent renewal.
United StatesFDA does not require periodic renewal of NDAs or BLAs — approvals remain in effect indefinitely subject to compliance, payment of annual program fees, and post-marketing requirements. Annual reports are required.

Pharmacovigilance

TurkeyTurkish Pharmacovigilance Centre (TÜFAM, Türkiye Farmakovijilans Merkezi) under TİTCK. PSURs aligned with ICH E2C(R2). Mandatory ICSR reporting via TÜFAM electronic system. Turkey is a WHO-UMC member.
United StatesMandatory expedited reporting of serious unexpected ADRs within 15 calendar days; periodic safety reports (PADERs/PAERs) for the first 3 years post-approval, then annually. PSURs in ICH E2C(R2) format accepted in lieu of PADERs by agreement. FAERS database receives spontaneous reports. Post-Marketing Requirements (PMRs) and Commitments (PMCs) tracked publicly.

Unlicensed access

Named Patient Supply

TurkeyAvailable
United StatesAvailable

Compassionate Use

TurkeyAvailable
United StatesAvailable

Emergency Import

TurkeyAvailable
United StatesAvailable

Parallel Import

TurkeyNot permitted
United StatesNot permitted

Clinical trials

CTA approval

TurkeyRequired
United StatesRequired

Ethics approval

TurkeyYes
United StatesYes

CTA timeline

Turkey60–90 days
United States30–30 days

GCP standard

TurkeyICH-GCP + Turkish GCP Guidelines (2008, updated)
United StatesICH E6(R3) (adopted via FDA guidance January 2025); 21 CFR 312, 314, 50, 56

Pricing & reimbursement

Price regulation

TurkeyRegulated
United StatesFree pricing

Reference pricing

TurkeyYes
United StatesNo

HTA required

TurkeyYes
United StatesNo

HTA body

TurkeySağlık Hizmetleri Genel Müdürlüğü (Ministry of Health HTA Department) + SGK reimbursement evaluation
United StatesICER (Institute for Clinical and Economic Review) — independent, non-binding