OBJECTIVES: Analyses were conducted on Republic of Srpska (RS) Health Insurance Fund (HIF) national prescription database. Analyses explored health expenditure differences in pharmaceutical consumption for the fiscal year 2011 versus 2010. RS HIF provides coverage for a population of 1.2 million. METHODS: RS HIF national prescription database was explored to determine expenditure breakdown by therapeutic category and the appropriate positive list designation. Key cost drivers and the differences between two fiscal years in each therapeutic category were identified. Positive lists A (drugs at reimbursement rate of 90%), A1 (drugs not registered with Agency for Drug Approval required to treat certain conditions at reimbursement rate of 90%) and B (drugs at reimbursement rate of 50%) were observed. RESULTS: In 2010, total expenditure for all prescription drugs was €36.5 million. In 2011, total expenditure for all prescription drugs was €43.2 million. Thus, there was a cost / consumption increase of 18.23% across the board. Cardiovascular therapeutic area carried most of the burden in 2010 and 2011 with the above average increase of 26.46% amounting to 31.44% of total consumption in 2011 CONCLUSIONS: Moderate increase in cost / consumption from 2010 to 2011 predominantly accounts for disease management medicines.