Pharmacies and Generic Medicines: The True Cost of Health

• The Moroccan pharmaceutical market is worth nearly 18 billion dirhams per year.

• Generics account for only 38% of the medicines consumed, compared to 70% in Europe.The price of a medication is set by decree, but cumulative margins (manufacturers, wholesalers, pharmacies) can reach

• 57% of the final price.Successive reforms have not sufficed to establish generics as a default prescription.

• I. A Regulated Market, but Lacking Transparency

The Moroccan price-setting system relies on a regulatory cascade: the manufacturer proposes a price, the Directorate of Medicines and Pharmacy (DMP) validates it based on the average prices of eight reference countries, then margins are applied to each stakeholder.

In theory, this method ensures a balance between accessibility and profitability. In practice, it remains opaque: decisions on price setting and revisions are not always published, and revisions are rare.
The consequence is clear: many molecules, especially imported ones, maintain prices higher than those observed in Tunisia or Egypt for equivalent therapeutic options.

II. The Paradox of Moroccan Generics

Morocco introduced generics in the 1990s, but the momentum has faded. Several barriers persist:

Mistrust from part of the medical community, fueled by lobbying from original manufacturers;

• A low awareness of generics among patients, often associated with 'inferior' quality;

• Delays in revising the prices of originals, which distorts the competitiveness of generics.

• The DMP claims that

over 8,000 specialties are registered, half of which are in generic form, but their volume share remains limited in prescriptions.III. Margins: The Core Issue

A box sold for 100 DH can generate up to 57 DH in cumulative margins among manufacturers, wholesalers, and pharmacists.

Pharmacists receive around

• 30 to 34%, capped by decree.Wholesalers keep about 10%

• while manufacturers capture the difference after deducting costs and taxes.This structure paradoxically incentivizes the sale of the most expensive medicines rather than the more economical ones.Some pharmacists concede that a low-cost generic 'turns over less' in their pharmacy, especially in areas with low patient density..

• IV. The Silent Lobbying of ManufacturersMajor laboratories (multinational and dominant local players) influence regulations: publication delays of decrees, maintenance of high prices, control over distribution channels.Patient associations also decry the slowness of the

pharmacovigilance committee
and the lack of an automatic substitution policy, which would allow pharmacists to dispense a generic without prior approval from the doctor.

As a result, generics remain often a 'moral choice' rather than a public health policy.

V. Consumers Caught in a Bind
Citizens pay more, not because of actual cost inflation, but due to a rigid structure and a

lack of effective competition

Some essential medications have only one or two suppliers in the Moroccan market, preventing natural price drops.

Awareness campaigns — 'Generics, same care, cheaper' — have had little impact due to a lack of consistent media support.VI. Paths to Genuine ReformExperts suggest three key areas:Make all price setting and revision decisions public;.
Allow automatic substitution
by pharmacists;

Create a stabilization fund

to compensate for price drops and protect local production.

1. Some also call for integrating CNOPS/CNSS reimbursement data to identify the most prescribed molecules and align public purchasing policies with actual market prices.Box — The Market in Numbers

2. Total turnover: 18 billion MAD350 accredited laboratories in Morocco

3. 8,000 registered specialties38% market share for generics

30% average margin for pharmacies

1.3% of GDP spent on medicines

• FAQ

• Why do generics remain a minority in Morocco?

• Due to cultural mistrust, laboratory lobbying, and lack of automatic substitution.

• Does the consumer benefit?

• Not much: despite announced decreases, intermediary margins maintain high prices relative to purchasing power.

• What could change with reform?

Price transparency, free substitution, and the digitization of distribution channels could finally align Morocco with international standards.

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