OBJECTIVES: To analyze the differences between manufacturer and retail prices of overlapping trademarks ACE- inhibitors, marketed in Slovakia (SK), Greece (GR), Bulgaria (BG) and Romania (RO).

METHODS:The study is retrospective comparative analysis. An average price per tablet was compared at manufacturer and retail level as value and average deviation. On total, 7 monoproducts belonging to ATC C09A and 12 fixed dose combinations (FDCs)(containing ACE- inhibitors, ATC C09B) were compared.The overlapping trademarks are collected from the official registers of the observed countries in November, 2017. All prices are converted in euro. Statistical significance of prices’ changes is tested with Kruskal-Wallis test.

RESULTS: The result shows the highest number of trademarks with the lowest manufacturer and retail prices is in RO (n= 12), while the smallest is in Bulgaria. The most significant deviation from the lowest price is found for ramipril, followed by ramipril/ hydrochlórotiazid (found in GR) and perindopril 10 mg (found in RO). In most of the cases the low manufacturer price lead to lower retail price. Exceptions are 5 trademarks as a result of the differences in pricing methodologies on national level, margins and taxes. Statistically significant differences between prices in 4 countries are not found.

CONCLUSIONS: The study reveals a slight variations between prices of ACE inhibitors and FDCs in 4 countries. The differences in pricing methodologies on national level could not influence significantly the final retail prices, as we found that low manufacturer price lead to lower retail price.