OBJECTIVES: To look into the impact of the drug policies in the Slovak Republic in 2006-2009. To evaluate drug policy in terms of drugs´ accessibility, extent of patients’ co-payments and introduction of innovative drugs. To compare market developments in Slovakia to its neighbors, and EU/OECD countries. METHODS: We calculated the impact of several regulatory measures on the size of the market and health insurance expenditure: a) Lowering the VAT for drugs from 19% to 10% b) flat price cut (-6.6% and -7.4%) c) introduction of degressive mark-up for wholesalers and for pharmacies d) two rounds of the international reference pricing.The data on drugs consumption were from national databases IMS Health and Pharmadata Ltd. We paired these data with reimbursement lists published by Slovak Ministry of Health. We compared trends in the Slovak drug market to market trends in neighboring countries and to OECD/EU markets. RESULTS: In 2006 through 2009, the actual calculated savings on publicly-covered drugs reached EUR 160mil due to the flat price cuts, €85mil due to two international reference pricing rounds and EUR 40 mil due to the degressive mark-up. The total volume of the Slovak market in 2009 was €1080mil in manufacturers´ prices, in a country of 5,4mil inhabitants. Consumption of drugs per capita reached app. €200. CONCLUSIONS: Slovak drug policy was able to significantly decrese the share of pharma expenditure in total health expenditure while increasing access new to drugs. Annual growth of the market in the period averaged 6.3% (1.4% in 2009), share of drugs in total health expenditure fell from 37% to 27%%, more than 100 new molecules s entered the market, and co-payments are astable  app. 12% of total drug expenditure. We noticed this trend of decreasing market growth also in west European countries, but in middle-east European countries the growth of drug market was increasing by more than 10% also in 2009.