OBJECTIVES: To compare health expenditure as total % of GDP, per capita PPP and in US dollars as well as total drug expenditure with top ten ATC groups with highest expenditure in 2009 and 2010 in Bosnia & Herzegovina (B&H) and Croatia (CRO). METHODS: Research was based on data published in latest official annual reports from two national Drug Agencies  and official reports from The World Bank. Top ten ATC groups were identified and compared for  the period of two years – 2009 and 2010. RESULTS: The Health expenditure in 2009 as total (% of GDP) in B&H was 10.94 and in CRO it was  7.83. Total drug expenditure in B&H was 238.8 mil EUR compared to 269 in 2010 (increase of 11,23%), while in CRO it was 625.6 mil EUR compared to 664.5 in 2010 (increase of 5,85%). Top 10 ATC 1st level drug groups with highest expenditure in both countries in 2009 and 2010 were rather similar but on ATC 2nd level we observed significant differences in the share of relevant ATC groups with leading C09, J01 and L01 for 2009 and C09, J01 and A10 for 2010 in B&H. Leading groups in CRO for 2009 were L01, J01 and C09, and for 2010 J01, C09 and L01. No drugs from C10 group were present in top ten ATC 2nd level in B&H. CONCLUSIONS: CRO has universal healthcare system with twice smaller increase in total drug expenditure compared to B&H. B&H needs unique essential drug list as it is a country with decentralized healthcare system including drug politics and positive reimbursement drug lists.