OBJECTIVES: In Egypt, the Ministry of Health and Population (MOHP) sets pharmaceutical prices from ex-factory to retail. In July 2012, the pricing policy changed from a cost plus to an external reference pricing method which was effective in October 2012. Our goal was to identify the characteristics of products with price changes after the policy implementation. Methods: We used MOHP lists and IMS data to pre-identify products with price changes. METHODS: We used MOHP lists and IMS data to pre-identify products with price changes. In addition, purchase and sales data were obtained from a chain pharmacy in Alexandria for all transactions pre- and post- the policy change (April - Jun 2012 and 2013) to validate price changes, assess sales activity, and identify any additional products with price changes. Bivariate analysis and a logistic regression model were done to identify the determinants of price increase or decrease per Daily Defined Dose (DDD). RESULTS: A total of 206 products were subject to price changes; 66% of the products had price increase, 70% were generics, 36% were essential drugs, 40% of the products had prices less than 1EGP[1]/DDD, 30% were between1 and 5EGP/DDD and 30% were higher than 5EGP/DDD. Half of the products were produced by domestic private companies, 27% by multinational firms, 21% by state-owned companies and 2% were imported. The products of state-owned firms had 23 times the odds of the products of multinational firms to have a price increase. Similarly, the cheapest products had 9 times the odds of a price increase compared to high priced products. Compared to brand name drugs, generics had 6.8 times the likelihood of a price increase.