OBJECTIVES:  To assess the procurement and patient price of selected medicines from a national list of essential medicines (NLEM) 2011 in pharmacies across India. METHODS:  Data on procurement and patient price of medicines were extracted from seven states in India (Delhi, West Bengal, Karnataka, Haryana, Maharashtra, Chennai and Rajasthan) conducted the medicine prices and availability survey using the World Health Organization/Health Action International methodology. Twelve medicines from NLEM 2011 which are commonly surveyed across all the states were included. Because different states conducted their survey at different years, data were converted into the base year of 2015 for comparison. Outcome measure was median (range) price ratios to international reference prices. RESULTS:  As there was no procurement of originator brand medicines in public sector, price was not calculated for this. The median (range) procurement price for generic medicine in public sector was highest in Rajasthan [1.44 (0.12-2.87)] and lowest in Chennai [0.38 (0.13-0.91)]. Patient price in public sector for generic medicine was nil in all the states as they are providing freely. Patient price in private sector for originator brands was found be highest in Maharashtra [15.44 (3.24-22.45)] and lowest in Chennai [12.75 (3.21-22.45)]; and for generic highest in the Delhi [14.22 (3.47-22.12)] and lowest in Rajasthan [9.27 (3.27-18.93)]. CONCLUSIONS:  Procurement price of essential medicines were low in Chennai compared to other states. Patients treated in private sector paying very high price for both originator brand and generic essential medicines.