Pooled and segmented procurement are common in public health, but changing needs may prompt method shifts. Understanding their impact on drug prices is crucial for informed policy decisions. This study aimed to evaluate the impact of procurement method changes from pooled to segmented (P → S) and from segmented to pooled (S → P) on drug prices within Malaysia's public health sector. A five-year retrospective analysis was conducted using data from eight therapeutic subgroups, covering 73 drugs and 151 comparative procurements. The product price index measured price changes between procurement groups, and differences in probabilities and price index were assessed using Pearson Chi-square and Mann-Whitney U tests. The significance level was p