Bangladesh’s pharmaceutical market is facing growing scrutiny over significant price differences between medicines containing the same generic ingredient. A tablet sold by one company for Tk 32 is available from another manufacturer for as little as Tk 8. In another case, 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 variations have raised questions about how medicine prices are determined, whether higher prices reflect better quality and how effectively consumers are protected. For patients who need regular medication, the differences can place an additional burden on household budgets.

Doctors and pharmaceutical industry representatives say medicines containing the same generic ingredient can offer comparable therapeutic benefits when they meet the required quality standards. However, experts argue that the absence of a sufficiently clear and transparent pricing framework leaves patients struggling to understand why apparently similar products cost so much more at different pharmacies.

Same Generic, Fourfold Price Difference

Belal, who regularly takes medication for a heart condition, has been prescribed a tablet costing Tk 32 per unit. Yet other pharmaceutical companies sell medicines containing the same generic ingredient for Tk 8 per tablet.

The difference means the more expensive product costs four times as much as the cheaper alternative. For patients who take medication every day, such a gap can translate into a substantial additional expense over time.

Many patients purchase exactly what their doctors prescribe, often without knowing whether less expensive alternatives are available. Others switch to cheaper products to manage their treatment costs, sometimes without consulting a healthcare professional.

This raises an important question: why do medicines containing the same generic ingredient have such different prices?

Doctors say that products containing the same active pharmaceutical ingredient should generally provide comparable therapeutic effects when they meet the relevant quality and regulatory requirements. However, having the same generic name does not automatically establish that two products are identical in every respect. Manufacturing standards, formulation, bioavailability and regulatory approval can also influence their suitability for particular patients.

The challenge for consumers is determining whether the price difference reflects meaningful differences in the products or is largely attributable to commercial considerations.

Pharmaceutical Industry Points to Branding

Pharmaceutical industry representatives identify branding as a major reason for price variations between products.

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 and was supplied to overseas markets as well as Bangladesh.

Kaiser Kabir, vice-president of the Bangladesh Association of Pharmaceutical Industries and managing director of Renata, said branding was a principal factor behind differences in medicine prices.

According to him, price variations are common in a free-market economy, where companies compete through brand positioning and promotional strategies. He also argued that the country of origin of raw materials alone does not explain why one medicine costs more than another.

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

Brand recognition, marketing expenditure and commercial positioning can influence the retail prices of medicines. Nevertheless, the scale of the differences has prompted questions about whether the pricing system adequately balances commercial interests with patients’ ability to afford essential treatment.

For people managing long-term conditions, even a modest difference in the price of an individual tablet can become significant when multiplied across daily doses and months of treatment.

Antibiotic Injection Sold at 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 cited in the report.

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

The substantial difference raises questions about the relationship between printed prices, actual retail prices and the distribution of medicines through the supply chain.

However, a medicine’s low selling price does not, by itself, prove that it is of inferior quality. Equally, a higher price does not necessarily guarantee superior therapeutic performance.

The reasons for a particular price difference need to be assessed by examining the product’s approved price, manufacturing costs, distribution arrangements and the applicable regulatory requirements.

Meropenem also highlights the importance of responsible medicine use. As an antibiotic, it should be administered according to appropriate medical advice. Patients should not change their prescribed antibiotic, dosage or treatment schedule solely to reduce costs without consulting a qualified healthcare professional.

Drug Administration Calls for Clear Pricing Rules

The Directorate General of Drug Administration (DGDA) has maintained that cheaper medicines should not automatically be considered inferior. The authority says it monitors medicine quality to ensure that products available in the market meet the required 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 the fact that a medicine was being sold at a lower price did not necessarily mean that its quality was poor. According to him, the administration maintained strict monitoring to protect quality, regardless of the price at which a product was sold.

However, he stressed the need for a clear government policy on medicine pricing. A transparent framework, he suggested, would help establish a more consistent basis for determining prices and improve confidence among consumers and industry stakeholders.

The absence of a sufficiently clear and widely accepted pricing framework remains a central concern in the debate. Questions persist over how manufacturing expenses, promotional costs, distribution margins and reasonable commercial returns should be reflected in the final price paid by patients.

A transparent pricing mechanism could help consumers understand the basis for price differences while giving manufacturers clearer guidance on how their products should be priced.

Concerns Over Gifts to Doctors

Experts have also raised concerns about the marketing practices of pharmaceutical companies, particularly allegations that gifts or other benefits offered to doctors may influence prescribing decisions.

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

The concern centres on whether commercial relationships could influence the choice of a particular brand when prescribing medicines. Medical decisions should primarily reflect patients’ clinical needs, the effectiveness and safety of the available treatments, and affordability where suitable alternatives exist.

Prescribing a specific brand is not necessarily inappropriate. However, experts say professional independence and transparency are essential to ensure that commercial incentives do not take precedence over patients’ interests.

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 remain reasonably consistent and that the government had a responsibility to bring pricing within a clear policy framework.

Patients Need Affordable and Reliable Treatment

Medicine is an essential component of healthcare, and its affordability can directly affect whether patients follow their prescribed treatment. People living with chronic conditions, including heart disease and diabetes, often need to purchase medicines continuously. Large price differences can therefore create particular difficulties for those on limited incomes.

Experts believe a more transparent pricing system should take account of manufacturing costs, quality-control requirements, distribution expenses and reasonable profit margins. Regulatory oversight should also ensure that medicines sold in the market meet the required standards and that pricing practices comply with applicable rules.

Patients, meanwhile, should not switch medicines solely because another product is cheaper. Those seeking lower-cost alternatives should consult their doctors or registered pharmacists to confirm that the alternative is appropriate for their condition and treatment requirements.

Such advice can help patients manage expenses without compromising the safety or continuity of their care.

The debate also underscores the importance of providing consumers with reliable information about generic medicines and their alternatives. When patients understand which options are medically suitable, they are better placed to discuss affordability with healthcare professionals.

The pharmaceutical industry maintains that differences in branding and other commercial factors help explain variations in prices, while the drug administration says lower prices do not necessarily indicate poor quality. Yet these explanations do not fully resolve the central question facing consumers.

If medicines containing the same generic ingredient can be sold at prices differing severalfold, patients deserve a clear explanation of the reasons. Effective regulation, transparent pricing and stronger oversight of marketing practices are essential to ensure that access to safe and effective medicines does not depend unnecessarily on a patient’s ability to pay more for a particular brand.