Bangladesh’s pharmaceutical market is facing growing scrutiny over substantial price differences between medicines containing the same generic ingredient. A tablet sold by one company for Tk 32 is available from another manufacturer for just Tk 8. Meanwhile, an antibiotic injection carrying a printed price of Tk 1,300–1,400 was reportedly being sold at a pharmacy in Dhaka for Tk 700.

The wide disparities have raised questions about medicine pricing, quality standards and the effectiveness of market oversight. For patients who need regular medication, the differences can add considerably to their healthcare expenses.

While pharmaceutical industry representatives attribute much of the price variation to branding and marketing strategies, experts argue that a clearer pricing framework and stronger regulatory oversight are needed to protect consumers from unreasonable costs.

Same Generic Medicine, Fourfold Price Difference

Belal, who regularly takes medication for a heart condition, has been prescribed a tablet costing Tk 32 per unit. However, medicines containing the same generic ingredient are available from other manufacturers for as little as Tk 8 per tablet.

The more expensive product therefore costs four times as much as the cheaper alternative. For patients who take medicines daily, such a difference can become a significant financial burden over time.

Many patients purchase exactly what their doctors prescribe, often without knowing whether more affordable alternatives are available. Others switch to cheaper products to reduce their treatment expenses. However, changing medicines without professional advice can create risks, particularly when differences in formulation, quality or suitability have not been properly assessed.

Doctors generally expect medicines containing the same active pharmaceutical ingredient to provide comparable therapeutic benefits when they meet the required quality and regulatory standards. Nevertheless, sharing the same generic name does not automatically mean that two products are identical in every respect.

Manufacturing processes, formulation, bioavailability and regulatory approval can all affect a medicine’s suitability and performance. The key question is whether the price difference reflects meaningful differences between products or is largely driven by commercial considerations.

Zakir Hossain, managing director of Delta Pharma, said most pharmaceutical companies in Bangladesh sourced their raw materials from broadly similar sources. He added that the medicine under discussion was among his company’s export products, supplied to markets both in Bangladesh and abroad.

Industry Attributes Price Differences to Branding

Pharmaceutical industry representatives say branding is one of the principal reasons medicines containing the same generic ingredient can have different prices.

Kaiser Kabir, vice-president of the Bangladesh Association of Pharmaceutical Industries and managing director of Renata, said branding played a major role in determining medicine prices.

According to him, price variations are common in a free-market economy, where companies compete through brand recognition, positioning and promotional activities. He also argued that the country from which raw materials are sourced does not, by itself, explain the differences in retail prices.

Claims about sourcing ingredients from Europe or other regions can sometimes form part of a company’s promotional strategy, he suggested. He added that various aspects of pharmaceutical production are subject to established quality standards.

Brand recognition, promotional expenditure and commercial positioning can influence the final price consumers pay. However, the scale of the differences has prompted questions about whether the market adequately balances business interests with patients’ ability to afford essential treatment.

For people living with chronic conditions, even a small difference in the price of a single tablet can accumulate into a substantial expense when multiplied across daily doses and months of treatment.

Antibiotic Injection Sold for Almost Half Its Printed Price

The price disparity is not limited to tablets. Meropenem, an antibiotic used to treat certain serious bacterial infections, provides another example highlighted in the report.

The injection reportedly carries a printed price of Tk 1,300–1,400, yet a pharmacy in Dhaka’s Shahbagh area was selling it for Tk 700.

The difference has raised questions about the relationship between printed prices and actual retail prices, as well as the factors influencing the cost of medicines throughout the supply chain.

However, a lower selling price does not automatically indicate inferior quality. Equally, a higher price does not necessarily guarantee better therapeutic performance.

Understanding why a particular medicine is being sold at a substantially lower price requires examining its approved price, production costs, distribution arrangements and applicable regulatory requirements. Proper storage and compliance with quality standards are also essential considerations.

Responsible use is particularly important for antibiotics. Patients should not change their prescribed medicine, dosage or treatment schedule solely to save money without consulting a qualified healthcare professional.

Drug Administration Calls for Clear Pricing Policy

The Directorate General of Drug Administration (DGDA) maintains that cheaper medicines should not automatically be considered inferior. The authority says it monitors products in the market to ensure that they meet the required quality standards.

Akhtar Hossain, a director at the drug administration, acknowledged that substantial price differences between products containing the same generic ingredient could confuse consumers.

He said a medicine’s low price did not necessarily mean its quality was poor. According to him, the administration maintained strict monitoring to ensure quality, regardless of the price at which a product was sold.

However, he stressed the need for a clear government policy on medicine pricing, arguing that an established framework would help build confidence among consumers and industry stakeholders.

The issue highlights the need for greater transparency in determining the prices of medicines. Manufacturing expenses, marketing costs, distribution margins and reasonable commercial returns all influence the final price. A clear policy could help establish how these factors should be assessed and identify instances of potentially unreasonable pricing.

Effective oversight would also help regulators examine unusual price differences and take appropriate action where necessary. At the same time, consumers would have a clearer understanding of how the prices of essential medicines are determined.

Concerns Over Gifts to Doctors

Experts have also raised concerns about pharmaceutical marketing practices, particularly the alleged practice of companies providing gifts or other benefits to doctors.

Some specialists fear that such arrangements could influence prescribing decisions and encourage the use of particular brands, even when suitable alternatives are available.

Chowdhury Mahmud Hasan, former dean of the Faculty of Pharmacy at the University of Dhaka, questioned why pharmaceutical companies should offer gifts to doctors. He argued that doctors should not accept such benefits.

Prescribing decisions should be based primarily on patients’ medical needs, the safety and effectiveness of treatment, and affordability where clinically appropriate alternatives exist. Professional independence is essential to ensure that commercial interests do not take precedence over patient welfare.

Prescribing a particular brand is not necessarily inappropriate. However, transparency and ethical standards are important to prevent commercial incentives from influencing clinical decisions.

Abul Kalam Azad, a professor in the Department of Medicine at Bangladesh Medical, said medicines from different companies could have minor differences in performance. Nevertheless, he argued that medicine prices should be reasonably consistent and that the government had a responsibility to bring pricing within a clear policy framework.

Patients Need Affordable and Reliable Medicines

Medicines are an essential component of healthcare, and their affordability can directly affect whether patients follow prescribed treatment. People living with heart disease, diabetes and other chronic conditions often need medication continuously, making substantial price differences particularly burdensome.

Experts believe a transparent pricing system should take account of manufacturing costs, quality-control requirements, marketing expenditure and reasonable profit margins. Regulatory oversight should also ensure that products meet the required standards and that companies comply with applicable pricing rules.

Patients, meanwhile, should not switch medicines simply because another product is cheaper. Those seeking affordable alternatives should consult their doctors or registered pharmacists to establish whether the alternative is suitable for their condition and treatment requirements.

Providing reliable information about generic medicines and their alternatives would also help patients make informed decisions. With appropriate professional guidance, they may be able to reduce unnecessary expenses without compromising the safety or continuity of treatment.

Pharmaceutical industry representatives maintain that branding and other commercial factors explain much of the price variation, while the drug administration says lower prices do not necessarily indicate poor quality. However, these explanations do not fully answer why products containing the same generic ingredient can cost several times more depending on the manufacturer.

A fair and transparent pricing system is essential to protect patients from unreasonable financial pressure. Clear rules, effective market monitoring and ethical marketing practices would help improve confidence in the pharmaceutical sector while ensuring that access to safe and effective medicines does not depend unnecessarily on a patient’s ability to pay a premium for a particular brand.