In most countries, high medicine prices are a consequence of high prices charged by manufacturers and/or high add-ons in the supply chain, such as wholesale and retail margins and government-imposed duties and taxes. Both of these factors, acting either singly or in combination, can substantially increase the final price of medicines to patients in both the public and private sectors. In the limited number of low- and middle-income countries for which data are available, private sector wholesale mark-ups range from 2% to 380%, whereas retail mark-ups range from 10% to 552% (4). In countries where value added tax (VAT) is.
