Abstract

Pharmaceutical pricing remains one of the most debated areas of healthcare policy because medicines simultaneously function as essential healthcare interventions and commercial products. In Pakistan, discussions surrounding medicine prices intensified deregulated the maximum retail prices (MRPs) of medicines excluded from the National Essential Medicines List (NEML). Public debate has increasingly focused on apparent differences between government procurement prices and retail pharmacy prices for medicines such as omeprazole, montelukast, escitalopram, pregabalin, atorvastatin, ceftriaxone, losartan, fluconazole, and numerous other pharmaceutical products. In several instances, procurement prices have been compared directly with retail prices, leading to claims of excessive markups or profiteering. However, such comparisons may be scientifically misleading unless the products being compared are identical in manufacturer, dosage form, pack size, procurement period, regulatory status, and commercial transaction conditions. This analytical review examines the scientific validity of comparing public procurement prices with open-market retail prices in Pakistan. It argues that procurement transactions and retail pharmaceutical markets operate under fundamentally different commercial, regulatory, and economic environments. Government procurement commonly involves competitive tenders, and reduced marketing costs, whereas retail pricing incorporates distribution expenses, inventory management, taxes, and other commercial factors.