The study focuses on reviewing factors that influence accessibility, affordability, efficiency in Nigeria’s pharmaceutical industry and its impact on healthcare delivery. Despite the Nigeria’s increasing population coupled with a high disease burden, it imports most of its drugs from India and China since its own pharmaceutical sector is not self-sufficient. The study noted certain difficulties such as poor infrastructure, inflation, exchange rate volatility, poverty and weak regulatory structure in the health sector made it tough for people to get access and afford basic medicines. The study deployed a semi-log regression to see how accessibility and affordability of medicines interact with the capacity of pharmaceutical sector in the Nigerian economy. Findings from the study revealed significant interrelatedness between level of access to essential medicines and the pharmaceutical industry contribution to GDP; other variables, such as costs of Malaria treatments, minimum wage, and inflation, showed weak or no statistical impact on the response variable. In conclusion, the study suggests that the federal government should discontinue the NHIS program to allow the private sector takeover this programme, this can free up resource and strengthen local pharmaceutical production, it also recommends applying regulatory measures to ensure medications are accessible and affordable for better health outcomes and a stronger economy.Keywords: National Health Insurance Scheme (NHIS), Accessibility, Affordability, Competitiveness.