The Moldovan pharmaceutical market is growing in terms of revenue, while at the same time seeing a decline in product variety. In 2025, drug sales at pharmacies reached 5.4 billion lei—25% more than in 2021—while the number of packages sold remained virtually unchanged. During the same period, 1,553 drugs were withdrawn from the market, while 845 new ones were introduced. Consumers are spending more money at pharmacies but have fewer options to choose from. Cheap drugs—whose availability was supposed to be protected by government regulation—are disappearing particularly quickly.
Against this backdrop, the Ministry of Health has presented a plan for a phased reform of the pharmaceutical market, aimed at restoring the availability of affordable drugs and reducing medication costs. The first changes have already begun with the simplification of registration procedures; however, new pricing rules have yet to be discussed and approved.
According to data from the Ministry of Health and the Agency for Medicines and Medical Devices, the net reduction in the product range for 2021–2025 amounted to 708 items, or about 16.5% of the 4,300 products available at the start of the period. These are specific product names with specific dosages and packaging: the removal of a product does not always mean the loss of a treatment option, but it may reduce choice and competition.
Medications with a manufacturer's retail price of up to 30 lei account for about 59% of the total net reduction in the product range. In this segment, 574 products were removed and 155 were added; the net loss was 419 items. The remaining low-cost prescription drugs increased in price by 11%, while over-the-counter drugs rose by 18%. The 30-leu threshold refers to the manufacturer's price, not the retail price at the pharmacy.
The reduction also affected essential medicines. A total of 640 prescription and 130 over-the-counter drugs in this category disappeared from pharmacies. For 56 key active ingredients available in 2021, not a single product remained in the pharmacy segment or the reimbursement system by 2025. Most of these substances were used in hospitals or were replaced by modern alternatives. However, seven substances for outpatient use disappeared without any alternatives from the same therapeutic group. In these cases, the issue is the availability of necessary treatment.
During the period under review, spending on prescription drugs increased by 33.6%, sales by package increased by 6.3%, and prices for identical drugs increased by 2.1%. This discrepancy is partly due to changes in the composition of purchases: total spending depends on which medications are purchased.
In the over-the-counter segment, consumers spent 11.4% more, even though they purchased 9.3% fewer packages. Prices for identical drugs rose by 12.5%, and prices for major over-the-counter drugs rose by 15.3%. The average price per package sold increased from 43.5 to 53.47 lei—a rise of nearly 23%—reflecting both price increases and changes in the sales mix. These figures show an increase in spending despite a decline in purchases.
The Ministry of Health attributes the disappearance of low-cost drugs, among other factors, to the tiered system of trade markups. Even a relatively high percentage markup on a low-cost package may generate too little revenue to cover delivery, storage, and dispensing costs. In a small market, the costs of managing a drug are spread across a limited number of packages, and annual price reapproval adds to the administrative burden. If distribution ceases to be profitable, the state-set price remains affordable only in name.
Regulation is not the only reason drugs are withdrawn from the market. The analysis also cites inflation, exchange rates, and manufacturers' commercial decisions. However, the government can directly change pricing rules and administrative procedures.
In the analysis presented, the actual markup was estimated at an average of approximately 10%—with a permitted maximum of 26%—while the net profit margin of independent pharmacies did not exceed 0.9%.
The current reform proposes changing the mechanism for approving manufacturers' wholesale prices, taking into account prices in comparable countries in the region. At the same time, preparations are underway to update the National List of Essential Medicines and the rules for importing unregistered drugs when the necessary medication is not available on the Moldovan market.
Subsequently, a review of wholesale and retail pricing is planned, including the phased liberalization of prices for over-the-counter drugs. Until the reform is completed, prices will remain regulated, and essential and reimbursable medicines must remain under full state control.
The sequence of these changes is important. Reducing administrative barriers can facilitate the entry of new suppliers. If price restrictions are eased before additional supply emerges, prices may rise faster than competition can begin to curb them. The Ministry of Health also warns of the risk of abrupt liberalization in a small, import-dependent market.
The stated savings from the reform amount to up to 375 million lei annually, but this figure remains an expert estimate based on initial drafts. About 199 million lei are attributed to the new rules, while the remaining amount is linked to price trends in the countries used for comparison. Of this 199 million, about 159 million comes from citizens' purchases at pharmacies, and 40 million from reimbursed medications, where the effect is split between health insurance funds and patient copayments. Potential additional savings for hospitals, amounting to 20–40 million lei per year, are mentioned separately.
The reform has an inherent contradiction: the return of low-cost drugs requires that their supply be cost-effective, while reducing consumer costs requires lower expenses, increased competition, or a redistribution of revenue within the supply chain. A single change to the price cap does not guarantee both outcomes.
The Ministry of Health expects to halt the reduction in the product range as early as the first year of the new rules' implementation and to restore seven key active ingredients for outpatient use that had previously disappeared. For the buyer, accessibility depends on two conditions: the medication must be available for purchase, and its cost must remain affordable. // 30.10.2026 - InfoMarket.