OBJECTIVES: Polices drafted and being implemented for regulating and containment of medicine prices, but still “access to affordable medicines” is a significant issue for all especially for the world’s poor, where the lowest priced medicines are unaffordable for them. Therefore, the aim was to identify and review the literature on international comparative approaches related to medicine price regulation, control, and its effectiveness. METHODS: In this scoping review to analyze the strengths and weaknesses of international approaches towards medicine cost containment and price regulation an extensive search was carried out to collect peer-reviewed research and review articles, discussion papers, public documents relating to medicine pricing policies. STARLITE principles were set as an indicator for search strategy. Key search terms used were “medicine prices”, “causes of high medicine prices”, “ approaches towards medicine prices control”, “national medicine policies”, “international approaches towards medicine price control”, “containment policies”, and “effects of pricing policy on medicine”. RESULTS: Multiple methods such as supply-side regulations and demand-side regulations/ incentives, reference-based pricing, equity pricing and WHO recommended policy options for improving medicine affordability and availability, value-based pricing to regulate medicine prices was reviewed. However, inadequate proof of actual policy impact was found that result in affordability, which indicates that access to affordable medicine is a distant goal. These policies or regulations were either less comprehensive, outdated and fell short in implementation especially in low and middle-income countries due to lack of funding, infrastructure or trained professional task force. Overall, none of the policy options was preferred considering its desired outcome. CONCLUSIONS: The authors found gaps in the literature and propose that international and national organizations to perform critical evaluation and research. We propose that pro-poor policies should be developed to have a real impact on the lives of the vulnerable population by paying less for, and access to affordable medicines.