OBJECTIVES Our team wanted to compare the economic effect of restricted market access and reference based pricing (RBP) vs. RBP alone in two consecutive periods, 2007—2009 and 2010—2012. METHODS We used the officially published cash flow statements and income statements from the financial reports of the National Health Insurance Fund (NHIF) for each of the years from 2007 to 2012. Then we compared the data about the expenditure for drugs, as well as the data about the budget control. RESULTS While restricted market access and RBP has been applied between 2007 and 2009, the NHIF drug expenditure increased with 15% (from EUR 144 mln to EUR 166 mln). For that period, the drug expenditure was generally 100% within the budget. From 2010 to 2012, while only RBP has been applied, the expenditure increased with 62% (from EUR 187 to EUR 303 mln). For the period, the drug expenditure exceeded the NHIF budget with 5% in 2010, 34% in 2011, 20% in 2012. CONCLUSIONS RBP alone cannot control the drug expenditure in a long-term. Additional measures are needed together with RBP. Performance-based pricing, differential pricing, comparative pricing, profit control and price-volume agreements may be considered as additional to RBP measures for pricing and budget control.