Introduction

Providing affordable access to essential medicines in developing countries remains a significant challenge, and it is an integral part of the global efforts to achieve Millennium Development Goals (Pécoul et al. 1999, UN.org 2015). Recent surveys show that essential medicines are available in only 58% of the healthcare facilities in the public sector and 67% in the private sector in developing countries. Also, the median prices of essential medicines are, on average, 2.92 and 4.62 times higher than international reference prices in public and private sectors respectively (MDC Gap Task Force 2015). To improve access to essential medicines, many developing countries regulate the prices of country-specific lists of essential medicines, adapted from the World Health Organization’s (WHO) model list to suit the local needs (IMS Health 2015; Hogerzeil 2004). The impact of such regulations depends as much on the design of the policy as on its implementation. Rarely if ever studies examine, in detail, the design, enforcement and compliance aspects of such price control regulations (see, for an exception, Bhaskarabhatla et al. 2016).