A hundred and five names for one ibuprofen

The register of medicinal products for human use keeps track of everything cleared for sale in Romanian pharmacies: 32,474 packages, carrying 7,398 commercial names, put on the market by 721 firms. Behind them stand 1,361 active substances.

The substance with the most names is ibuprofen. It appears in the register under 105 commercial names, coming from 40 firms and spread across 414 authorised packages. They are the boxes below, each with the name written on it.

This crowding is the speciality of a handful of substances. Of the 1,361 in the register, 508 carry a single commercial name, and the median is two: the ordinary substance is sold under one or two names.

Second place belongs to rivaroxaban, with 77 names from 19 firms, an anticoagulant available on prescription only, whose European patent expired recently. Apixaban follows with 55 names and paracetamol with 53. Names pile up at two doors at once: the open shelf, where anyone buys without asking, and the patent that has just fallen, where every manufacturer walks in the same year.

The tool below reads the same register. Type the name on the box in your drawer — or the name of the substance, if you know it — and you will see which molecule sits underneath, how many other brands carry it and, wherever the price catalogue holds identical boxes side by side, what each one costs.

The Ministry of Health publishes a catalogue giving the highest price at which each box of prescription medicine may reach the pharmacy shelf. It is a ceiling, so a pharmacy may charge less and never more. The catalogue in force in August 2026 holds 6,485 entries.

To compare fairly, we placed side by side only the boxes that differ in nothing at all: same substance, same strength, same form and the same number of units inside. That yields 475 such groups, holding 1,570 boxes between them. The clearest one to read is sildenafil at 100 milligrams, in boxes of four film-coated tablets.

Between the cheap end and the dear one lie 133.86 lei, which is 5.08 times the price of the box on the left. Both hold four tablets with a hundred milligrams of sildenafil.

Sildenafil is the most visible case, and the same distance repeats across the catalogue. Measured across all 475 groups, the ratio between the dearest and the cheapest box has its median at 1.56. In 155 groups, close to a third of the total, the dear box costs at least double the cheap one. Only 47 groups, roughly one in ten, carry a single price across every product.

The widest gap in the catalogue belongs to deferasirox at 180 milligrams, a medicine that clears excess iron from the blood of people who receive transfusions all their lives. The box of thirty tablets costs 93.03 lei from the cheapest manufacturer and 1,290.71 lei from the dearest, 13.87 times as much.

The familiar story about medicine prices has two actors: the firm that invented the molecule and held it under patent, then the cheap copies that arrive when the patent falls. The catalogue shows more actors, arranged differently.

There are 141 groups of identical boxes in which an originator faces at least two generics. In 56 of them, that is two in five, the distance between the cheapest and the dearest generic exceeds the distance between the cheap generic and the originator.

The explanation lies in how the ceiling is set: the maximum price of each box is calculated from the lowest price of the same product across twelve reference countries, and every firm brings its own European price history into that calculation. The result is that the label "generic" tells you who made the box and says nothing about what it costs.

The price ceiling covers medicines dispensed on prescription. The 2,887 packages sold without one, nine per cent of the register, set their price freely, according to the manufacturer and the pharmacy.

Here the two halves of the story meet in an uncomfortable way. Ibuprofen, which carries more names than any other substance in the country, appears in the catalogue with two comparable groups, both of them in the high-strength prescription range. Paracetamol, with 53 names, has none. Precisely where the buyer chooses among fifty or a hundred boxes, there is no public list to check the price at the till against.

The register says what is allowed to be sold, which stays different from what sits on the shelf today: a valid authorisation can go unused for years. The prices above are ceilings, so a box may cost less, and they never say what the patient pays out of pocket after reimbursement. For reimbursed prescriptions, the share met by the health insurance house is worked out separately, on other lists.