OBJECTIVES: The incidence of diabetic in Middle East North Africa (MENA) region estimated as 9.7% with annual heath expenditure reached $16.8 billion in 2014. One of the tools to lower diabetes cost is control antidiabetic prices. The objectives of this study were to provide an overview and comparisons of the prices of antidiabetic drugs in the four Arabic countries: Saudi Arabia, Jordan, Oman, and Lebanon.METHODS: A cross-sectional study that looked at the prices of antidiabetic drugs marketed in four Arabic countries as of January 2018. Regulatory information and prices were obtained from ministries of health and food and drug authorities. Retail prices were used as a unit of analysis. Prices were converted to 2018 Saudi riyals (SR). Descriptive statistics were performed. RESULTS: Prices of antidiabetic drugs varied by therapeutic classes. Price of insulins varied type, Saudi Arabia had the lowest prices of rapid acting insulins (median 168.00 SR) while Lebanon had the highest (203.00 SR) (P=0.0012). Saudi Arabia had the lowest prices biguanides and sulfonylureas with median prices of (12.55, 22.25 SR respectively). Median DDP4 prices ranged from 113.00 SR in Saudi Arabia to 146.00 SR in Jordan. Median SGLT-2 prices ranged from 159.00 SR in Saudi Arabia to 233.00 SR in Lebanon. Median GLP-1 prices ranged from 416.00 SR in Saudi Arabia to 613.00SR in Oman. CONCLUSIONS: The prices of antidiabetic drugs were lower in Saudi Arabia compared to some Arabic countries, which might indicated the usefulness of reference based pricing for such products to lower the increased expenditure in Saudi Arabia.