OBJECTIVES: To analyze the development in the medicines pricing regulation in Republic of Macedonia during 2005 to 2010 and its impact on medicines affordability. METHODS: Regulatory analysis of the changes in the medicines prices regulation for the period 2005 to 2010 was applied. The affordability of the medicines to the population was explored before the after the new regulation introduction. Affordability was evaluated through the comparison of the cost of therapy of the most frequent diseases with the inhabitants wages. For comparison purposes, the average monthly wages in January 2005 (7.999,00 MKD) and in January 2010 (14.914,00 MKD) were used as announced by the UJP (Public Revenue Office of Macedonia). The statistical test used was Wilcoxon Matched Pais Test.   RESULTS: The unified medicines prices were established in 2007 based on ex-factory price, wholesale mark-ups and pharmacy mark-ups. The Health Insurance Fund carried out the supply of medicines on the Positive list by international tenders until 2005.  The reference pricing was introduced in 2007 and it took into consideration the Purchasing Parity Power.  The statistical analysis of the cost of treatment for selected health conditions compared with the average monthly wages, expressed as working hours shows that less working hours are needed to purchase medicines for all clinical conditions in 2010 compared to 2005.  There is statistically significant difference in the working hours needed to purchase medicines between 2010 and 2005 (Wilcoxon Matched Pairs Test: Z = 2240, p = 0, 0250). The better financial affordability of medicines in 2010 is a result of partly lower medicines prices, but predominantly a result of higher monthly wages.  CONCLUSIONS: The analysis reveals the positive impact of medicines price control and reference pricing on medicines affordability. The number of working hours needed to purchase a month of treatment decreased.