Bangladesh’s medicine pricing debate has returned to the spotlight, with economists, pharmaceutical industry leaders, legal experts and public health specialists calling for a balance between affordability, market viability and regulatory oversight.
The issue was discussed at the Policy Research for Development (PPRC)’s Ajker Agenda webinar on Saturday, where participants examined the country’s medicine pricing framework and challenges in ensuring affordable access to essential drugs.
Dr Syed Abdul Hamid of the Institute of Health Economics at the University of Dhaka said the government-led system for adjusting medicine prices often causes delays because of concerns over public reaction.
“Because medicine price adjustments are handled by government-led committees rather than an independent regulatory body, necessary updates are stalled out of fear of public backlash,” he said.
He noted that neighbouring countries regularly adjust medicine prices without similar political sensitivity.
Dr Syed Abdul Hamid also stressed greater investment in research and development as Bangladesh’s pharmaceutical sector prepares to shift from conventional generic medicines to biologics.
“If we do not focus on R&D for the shift from generic to biologic medicines right away, we will see further exodus of domestic patients seeking treatment abroad,” he said.
Dr Rumana Huque of the University of Dhaka’s Department of Economics highlighted shortages of medicines in public healthcare facilities, particularly in rural areas.
She said Essential Drugs Company Limited (EDCL) supplied medicines worth Tk830 crore in FY2021-22 for free distribution through public healthcare facilities.
However, shortages continue to force patients to buy medicines from private pharmacies, increasing their out-of-pocket healthcare costs.
“There is also the problem of over-prescription and inappropriate and excessive use of antibiotics and vitamins,” she said.
Kaiser Kabir, CEO of Renata Limited, argued that Bangladesh’s pharmaceutical market is already highly competitive, making direct price regulation unsuitable.
“Medicine prices in Bangladesh remain among the lowest globally because intense local competition drives down supply chain costs,” he said.
“Direct price regulation simply does not work in our market structure.”
He called for targeted government procurement and subsidized distribution of medicines for critical illnesses.
“To ensure UHC, government should prioritize targeted procurement and subsidized distribution of medicines for critical care diseases such as cancer,” Kabir said.
Advocate Jyotirmoy Barua of the Bangladesh Supreme Court questioned the legal basis of the current medicine pricing system.
He said the 1982 Drug Control Ordinance gave the government clear authority to regulate medicine prices, while the Drugs and Cosmetics Act 2023 narrowed that authority.
“Under the 1982 Drug Control Ordinance, the state maintained clear authority to regulate medicine pricing,” Barua said.
“Surprisingly, with the enactment of the Drugs and Cosmetics Act 2023, the government voluntarily curtailed its own oversight, indicating it would only regulate prices for a specific list of essential medicines, a list that has yet to even be published.”
Public health expert Dr Mushtuq Husain cautioned against scrapping the existing pricing framework despite its shortcomings.
“While the 2026 drug and medicine pricing guidelines may not fully reflect every stakeholder’s input, that alone does not justify scrapping the framework entirely,” he said.
“Rejecting it outright is not the right approach.”
M Mosaddek Hossain, senior vice president of the Bangladesh Association of Pharmaceutical Industries, said prolonged negative margins have affected the availability of some essential medicines.
“Several drugs on the Essential Drugs List have vanished from the market due to prolonged negative margins,” he said.
He argued that market competition should play a greater role in determining prices of essential medicines rather than relying solely on fixed administrative controls.
“Ensuring availability and quality are two essential concerns,” Hossain said.
Moderating the webinar, PPRC Executive Chairman Hossain Zillur Rahman linked the pricing debate to Bangladesh’s preparations for graduation from the Least Developed Country category.
He stressed targeted government intervention to protect vulnerable patients as Bangladesh faces changes to intellectual property exemptions following LDC graduation.
“The medicine pricing debate reflects a broader systemic challenge we must address before losing IP exemptions post-LDC graduation,” he said.
He suggested targeted procurement for high-mortality non-communicable diseases as a potential healthcare safety net on Bangladesh’s path towards Universal Health Coverage.
The discussion underscored that affordable medicines may require more than direct price controls. Participants pointed to a combination of competitive markets, targeted procurement, subsidies, effective regulation and stronger domestic research capacity.
As Bangladesh’s pharmaceutical sector faces a changing regulatory and intellectual property landscape, the challenge will be to keep medicines affordable while ensuring the commercial viability, quality and availability of essential drugs.
