And in the public health care sector, prices are lower than in the private sector. For example, for the asthma inhalant, Ventolin, the South African private sector pays 28.99 rands while the state sector pays 5.66 rands. The world average price is 22.86 rands. Although drug manufacturer prices in South Africa are among the lowest in the world, its retailers' markups in the private sector are among the highest. By comparison, the manufacturer's price is 65 percent in Germany and 88 percent in Sweden.
Retail margins are high due to cartel-like distribution in a noncompetitive retail market.