OBJECTIVES: Pharmaceutical policy of Armenia lacks the strong system aimed to regulate medicinal prices. During the recent years drug prices have been changed considerably, mostly increased and lead to public complains related to the accessibility issues. We aimed to estimate and compare the retail prices of essential and highly demanded generic medicines in the capital city.

METHODS: Study drugs were selected considering the list of essential medicines approved by the ministry of health, the order N 17 put in effect in 2013.Further selection was based on screening and identification of highly demanded essential drugs (HDED). Taking into account the time and resource constrains it was decided to randomly select only 40 drugs from the list of HDED. The other sampling was implemented to identify targeted pharmacies for collection of price information for HDED. Pharmacies were selected from all 12 districts (overall 741 pharmacies in Yerevan) where the interviewer was instructed to visit each pharmacy on the approximate distance of 1 kilometer until more than 50% of pharmacies participate within each district.

RESULTS: Data regarding selected HDED prices was retrieved from 383 pharmacies. The refusal rate was approximately 7%. The average prices for the same product of the same dose and form did not differ significantly in 12 districts (p>0.05). The highest prices were identified in the biggest center of Yerevan and the minimum prices were recorded in the area where most of the inhabitants are insolvent. To understand the mechanisms laid in the price generation the collected prices were compared with the nominal wholesale prices. And for all drugs we received significant difference (p>0.000) from its nominal prices.

CONCLUSIONS: Drug prices in Yerevan are self-regulated based on market competition. The high mark-ups are generated mostly through the highest in the region value added tax (20%), unregulated competition among the wholesalers and individual pharmacies.