In the past Latvia was the main location for biotechnology in the former Soviet Union. Highly qualified specialists and experienced management are still available, which is a valuable asset to the pharmaceutical industry in the country. A large proportion of the Latvian pharmaceutical market is dominated by import drugs. Local drug manufacturers are export-driven, serving mainly the markets of Russia, CIS and Poland. Compared to neigbouring Lithuania, the wholesale & retail sector in Latvia shows a greater concentration with 3 leading wholesalers and around 1‘000 pharmacies. Drug producers and marketers are confronted with fixed mark-ups and tight price control for reimbursable medicines. The pricing of non-reimbursable pharmaceuticals remains out of the scope of govermental regulations. As a consequence of the global economic crisis, and financial austerity measures of the Latvian state, patients are expected to face an increase of the VAT on medicines and hence higher copayment levels.