By Anton Geissler
Imports of foreign pharmaceuticals make up the bulk of medication available in Armenia. According to Enterprise Armenia, the pharmaceutical sector had an estimated market value of $220 million in 2025, while imports accounted for $ 201 million, making Armenia heavily dependent on imports and vulnerable to supply shocks.
Imported medicines are subject to Armenian registration, but with the launch of Universal Health Insurance last January, the government selects specific foreign and domestic drugs to reimburse. According to the Universal Health Insurance Fund’s report for the first half of 2026, 1,339 medicines are fully or partially paid for. So far this year, the state has reimbursed $40 million for medications alone.
What drugs are reimbursed and at what prices reveal how the Fund balances between dependence on Russia and the EU.
Russia accounts for the largest number of foreign-made medicines on the Fund’s reimbursement list, with 255 drugs, followed by Germany with 131.
This dependence on Russia is reflected in 2025 import data, where the country accounted for almost 30% of total medicine imports by weight, according to the UN Comtrade Database.
However, a more nuanced picture emerges when comparing European and Eurasian trade blocks. Under the new health insurance, the Armenian government reimburses 567 drugs from the EU, compared to 360 from the Russia-led Eurasian Economic Union (EAEU).
Origin of reimbursable medicines:
The EU has been an important pharmaceutical partner for decades, accounting for 60% of total imports of medicines, despite Armenia’s membership in the EAEU. The Eurasian block has common market authorization procedures that should make trade easier between the countries, but the EU remains a major partner for Armenia.
However, imports from this block are amongst the more expensive. Comparing data for the EU and EAEU, both unions accounted for around 40% of total medicine imports by weight. In contrast, EU imports totaled $117 million, compared with $25 million from the EAEU. For the same weight, European drugs cost almost six times more.
The average reimbursements from the Universal Health Insurance Fund also differ substantially. The average reimbursement per imported drug from the EU is $2.79, compared with $0.73 from the EAEU.
Average reimbursements per country map.
Part of this difference can be attributed to the high cost of unique EU imports. Eight of the ten most expensive reimbursable drugs are exclusively imported from the EU.
However, many medicines are also available from both EU and EAEU countries, dispersing supply chain risks. Drugs such as 80 mg Atorvastatin tablets and 10 mg Bisoprolol tablets, used to prevent heart attacks, are available from both Germany and Russia. However, the German equivalent costs 3-4 times more.
While many drugs are sourced from two or more countries, some are imported from a single foreign producer. 16 reimbursable drugs, listed as essential medicines by the WHO, and the Armenian Medical Products Regulatory Authority, are exclusively imported from a single producer in Russia or Belarus. These drugs are used to treat conditions such as fungal infection, poisoning, and bipolar disorder.
In turn, 23 essential medicines are only sourced from a single EU manufacturer.
According to the WHO, these drugs “should be available, affordable, and of assured quality at all times”, making their single source a potential vulnerability for Armenia’s healthcare.
Two notable countries, the United States and Turkey, are excluded from the Universal Health Insurance’s list of reimbursable medicines.
While 16 drugs are approved by the Ministry of Health for import from the United States, according to the Armenian Medical Products Regulatory Authority, none are included under Universal Health Insurance.
Armenia’s total imports of medicines from the United States amounted to $8.2 million in 2025, making it the 9th-largest partner. Cost may explain why the Armenian government does not reimburse drugs from the United States. According to data on 2025 Armenian imports, they cost 24 times more per kilogram than the average imported drug.
The country ranked 60th in 2025, with imports totaling $39,000, despite its status as the region's main drug producer. For comparison, Georgia imported $172 million in medications from Turkey. Here, the ban on direct trade between the countries, lifted only in May 2026, may explain the decision not to reimburse and approve many drugs. Further normalization with Ankara could diversify supply and reduce the cost of drugs in Armenia.
Similarly, while 49 Indian medicaments are reimbursed, Armenian imports from India trail those of Georgia. The country imported $3.3 million worth of medicines in 2025, compared to Georgia’s $ 27 million, presenting another reason for the higher cost of drugs in Armenia.
Another development is the increase in domestically produced drugs. Over the last 5 years, medicinal exports have doubled to $21 million, and 152 of 304 domestically produced drugs are now available through Universal Health Insurance.
While Armenian production reduces import dependence, these drugs are unlikely to significantly reduce the price of drugs. On average, the government reimburses $3.41 per Armenian-produced drug, slightly more than the European average and four times more than the EAEU average. This is mainly because Armenian companies focus on high-cost drugs. Comparing the same drugs from Armenian and international companies reveals that Armenian drugs, on average, are only $ 0.004 cheaper.
The Universal Health Insurance Fund balances Armenia’s dependence on EU and Russian or Belarusian imports, reflecting 2025 imports, where both regions are a major source of medicines. However, as Universal Health Insurance expands towards 2029, cheaper alternatives from Turkey, India, and China could represent an untapped asset for Armenian healthcare.
Stories
