In 2010, UNRWA spent about US$ 18.31 million on medicines. Of this, US$ 15.4 million came from their General Fund .With budget constraints and increasing demand (primarily medicines to treat diabetes and cardiovascular disease), there was a need to assess the efficiency of the medicine procurement process, in particular the procurement price of medicines. Of the 143 medicines that UNRWA procured in 2010 from the General Fund, 80 were initially selected for price comparisons (equating approximately to the top 80 medicines by expenditure). Of these, 77 were purchased centrally (by tender). Their prices were compared with median supplier prices in Management Sciences for Health’s (MSH) International Drug Price Indicator Guide, prices offered by IDA Foundation, and 2010 tender prices for Jordan’s Joint Procurement Department (JPD) and the Gulf Cooperation Council (GCC). Overall, UNRWA prices were equal to or less than MSH, JPD, GCC and IDA (blister packs), and 12% more than IDA prices (bulk packs). Based on the quantities purchased and price of each medicine, overall expenditure would increase if UNRWA purchased at IDA, JPD or GCC prices. However, if a limited list of 9 medicines could be purchased at comparator prices, savings of about US$ 1.6 million might be achieved (about 10% of General Fund medicine expenditure). There are a few cases where companies are charging UNRWA a higher price despite larger quantities procured than they charge JPD or GCC.