Brand diversity and cost variation among registered anti-diabetic medicines in Pakistan and Saudi Arabia: a comparative analysis for cost-saving opportunities

Abstract Background Diabetes mellitus is a highly prevalent disease that requires lifelong pharmacological treatment, significantly contributing to its high economic burden. This study aimed to explore the price variation among registered anti-diabetic medicines in two contrasting pharmaceutical markets. Methods A data-based cross-sectional study was conducted from May to August 2025 using official databases of Pakistan (DRAP) and Saudi Arabia (SFDA) to collect data regarding registered anti-diabetic medicines. The registered brand data were presented in terms of percentage contributions, cost ratios, and percentage price variations between the highest and lowest cost brands. Price data were converted to international dollars using purchasing power parity conversion rates for comparison. Results A total of 1,069 and 272 anti-diabetic medicine brands were registered in Pakistan and Saudi Arabia, respectively. Sulfonylureas represented the highest proportion of single-drug formulations, with Glimepiride showing the highest price variation among its brands. Fixed drug combinations of DPP-4 Inhibitors and Biguanides have the highest brand contribution and price variation in both countries. In Pakistan, the top 10 price variations were above 300% with a maximum of 769%, while in Saudi Arabia, the top 10 price variations were above 150% with a maximum of 467%. The median prices of anti-diabetic medicines were higher in Saudi Arabia in comparison to Pakistan. Conclusion This comparative analysis revealed that brand load has a substantial impact on price variation. Highlighting the need to address brand proliferation as a strategy to enhance the affordability of diabetes care, particularly in resource-constrained settings where out-of-pocket expenditures predominate.