OBJECTIVES: IEGM (General Directorate of Pharmaceuticals and Pharmacy) is responsible for setting all human medicinal products prices. Reference pricing system is used for setting prices. Reference countries are reviewed annually and may be subject to certain alterations. The aim of this study is to show the distribution of reference countries which were used for reference pricing. METHODS: The price list of pharmaceuticals which was published by IEGM on 15.04.2011 was used for the analysis. Distribution of reference countries and prices were evaluated. RESULTS: Prices of 6251 jeneric and 3703 original products were set. 5283 of jenerics and 3306 of originals were in the positive list for reimbursement. Reference pricing was used for 2352 jenerics and 2281 originals. Prices of the remaing were set outside of reference pricing. 32 different countries were used for reference pricing. Italy was the most popular country for reference pricing (24.47%). Italy was followed by Spain (21.96%), Greece (19.69%), France (11.8%) and Portugal (8.7%). Even if Germany was not a reference country, Germany was used in 3.71% of pharmaceuticals. Other 25 countries were used by 13,29%. However the ranking was changed only in pharmaceuticals with prices above 200 Turkish Liras (TL) or original pharmaceuticals; Greece was the most popular country in these rankings by 27.85% and 24.25%, respectively. Italy was the most popular country for reference pricing in sub groups like generics, prices ranging between 0 and 50 TL, 50 and 100 TL, and 100 and 200 TL. CONCLUSIONS: It has been shown that Italy has the highest impact on the pricing of all pharmaceuticals in Turkey. Greece has the highest impact on the pricing of originals. Even if Germany was not a reference country, it has been seen that it affects pharmaceuticals more than other countries which were also not used for reference pricing.