Access to medicines depends on a number of interconnected factors: Medicine prices, one of the most common factors can be affected by the manufacturer¿s selling prices, duties, taxes, patent legislation and mark-ups along the supply channel. The South African government has passed price legislation prohibiting discounts and rebates in the pharmaceutical sector by setting a single exit price for all manufacturers and a fee-for-service logistics fee for wholesalers, distributors and dispensing fee for retailers as compensation. In this study the South African mark-up structure related to medicine prices is going to be analysed because of its tribulations in implementing a transparent wholesale reform and the fact that it was once classified under the nine countries from the WHO African Region for analysis of data from their Medicines Prices Surveys.