OBJECTIVES: The prices of medicinal products paid by public funds in Bulgaria are regulated according to the legislation on the basis of the lowest manufacturer price of the same product in seventeen European countries. The Positive Drug List includes medicinal products which are paid by the National Health Insurance Fund (NHIF), medicinal products paid from the budget of the hospitals and medicinal products for treatment of AIDS, infectious diseases, as well as vaccines, specific sera, immunoglobulins, paid by the Ministry of health (MH).  The goal of the study is to determine the influence of external and internal reference pricing as a cost containment measure for one year period. METHODS: The analysis is made on a basis of cost for medicinal products paid by NHIF, MH and hospitals based on the reference value of each INN during 2014. We analyzed the changes in reference value of INNs. Only the official prices are used, i.e. we did not take into account the confidential discounts. RESULTS: In PDL medicinal products are grouped by INN and pharmaceutical form and the reference value within the group is set on a basis of the cheapest product. The prices of medicinal products included in PDL are checked every 6/12 months. For medicines paid by NHIF, the reference value of 85 INNs is reduced, the reduction ranges from 0.14% to 55.27% and total savings are 10,319,703 BGN. 31 INNs in oncology medicines for hospital use have reduced reference value and total savings are 9,852,593 BGN. For medicinal products paid by MH, 10 INNs have reduced reference value and total savings are 2,077,892 BGN. CONCLUSIONS: Analysis of changes in the reference values of medicinal products indicates that external and internal reference pricing is a good basis for saving public funds, but other cost containment measures are also needed.