The government's decision to revoke the Essential Medicines List 2026 and the Drug Pricing Mechanism 2026 on the pretext of procedural irregularities in their formulation is as absurd as it is unjustifiable. Medicine is a public good, and it is essential for the government to regulate the prices of life-saving drugs. In fact, lowering the prices of essential medicines was an electoral pledge of the incumbent BNP government. During the election campaign, it even promised to provide basic essential medicines and vaccines free of cost. But the decision to scrap the updated list of essential medicines not only runs counter to its pledge but also smacks of favouring the commercial interests of pharmaceutical companies at the expense of public health.
The interim government had expanded the essential medicines list and introduced several reforms to the drug-pricing system aimed at keeping the prices of life-saving medicines under control. Under the new pricing policy, 295 generic medicines were brought under price regulation. This marked the first update to the essential medicines list since 2016, when it contained 285 types of medicines.
Strangely enough, if there was a problem with the way the 2026 list was prepared, the government could have reverted to the 2016 list. Instead, it has decided to fall back on the 1994 medicines policy, which contains only 117 generic medicines. Public health experts said around 40 per cent of the medicines on the old list are either no longer in use because they have become ineffective or are no longer the preferred treatment options due to advances in medical technology. The decision to step back to a three-decade-old policy is being criticized as irrational and out of step with current healthcare needs.
What makes the decision even more perplexing is the government's justification for scrapping the updated list. It has argued that the interim government prepared the 2026 list and that the pricing method was adopted without consulting the National Drug Advisory Council (NDAC). But this argument does not seem persuasive. Under the Drugs and Cosmetics Act 2023, the NDAC has an advisory role; its approval is not a legal prerequisite for publishing an essential medicines list. If there were genuine concerns about the process followed by the interim government, the logical course would have been to review and correct the list rather than revive a policy that is more than three decades old.
The timing of the decision is also questionable. Pharmaceutical companies had already challenged the 2026 list and pricing method in the court. On January 22, the High Court issued a rule asking the government to explain why the updated list and pricing method should not be declared illegal. The matter was therefore sub judice. Rather than defending its position before the court and allowing the judiciary to settle the dispute, the government has effectively rendered the case irrelevant by withdrawing the updated policy. Such a move hardly provides a sound basis for long-term medicine policy.
There is another important legal dimension that cannot be overlooked. Under Section 11 of the Drug Regulation Ordinance 1982, the government had the authority to regulate medicine prices. Exercising that authority, the health ministry issued a gazette notification in 1993 covering 739 medicines. A year later, however, a government circular drastically reduced the number of medicines subject to price regulation to 177.
The legality of that 1994 circular was subsequently challenged. In 2018, Human Rights and Peace for Bangladesh filed a public interest litigation against it. In a landmark judgment on August 25, 2025, the High Court ruled that the government, rather than pharmaceutical manufacturers, must fix and publish the prices of essential life-saving medicines. It also declared the restrictive 1994 health ministry circular illegal. Against this backdrop, health experts have questioned the government's decision to revive a policy that has already been struck down by the court, saying it risks undermining the spirit of the court verdict.
Moreover, at a time when low- and middle-income households are grappling with the rising cost of living and mounting healthcare expenses, the government must strengthen price regulation of life-saving medicines, not weaken it. The repeal could render the regulatory framework largely ineffective, giving pharmaceutical companies free rein to set prices. As expected, the association of pharmaceutical companies welcomed the government's move.
The immediate concern is that the prices of the 180 medicines removed from the updated list could now rise. The medicines cover a wide range of treatments, including those for pain and fever, infections, heart disease and hypertension, gastrointestinal disorders, epilepsy and other neurological conditions, as well as medicines used in anaesthesia and surgery. The World Health Organization (WHO) says essential medicines should be widely available in adequate quantities and at affordable prices. More than 150 countries maintain national essential medicines lists to guide procurement, public supply, reimbursement and price regulation. Price regulation is particularly important for essential medicines, as unchecked price increases can put life-saving treatment beyond the reach of low- and middle-income families and undermine access to basic healthcare.
The need for effective price regulation is a vital issue in Bangladesh, where price manipulation is rampant and patients bear an exceptionally high share of healthcare costs. Government data show that out-of-pocket health expenditure (OOPE) accounts for nearly 80 per cent of total health expenditure, with medicines alone consuming almost two-thirds of that spending. By comparison, OOPE is around 40 per cent in India, 10 per cent in Thailand and 18 per cent in the Maldives. In such a situation, allowing the prices of essential medicines to be determined by market forces would only deepen the financial hardship faced by ordinary people and push healthcare further beyond the reach of the poor. The government must therefore reconsider its decision, and take decisive steps to honour its electoral commitment of reducing the cost of essential medicines and ensuring universal healthcare.
