If you move from the UK or North America to Italy, you may be in for a shock the first time you head to the shops for some basic painkillers.

Not only will you not find standard headache pills like paracetamol or ibuprofen in most Italian supermarkets, the price you’ll pay at the pharmacy is often ten times the cost back home, with a box of 20 paracetamol costing almost six euros in Italy versus 49p (around 0.6 euros) in the UK.

So why are basic cold and flu medications priced so much higher in Italy?

Italy has strict rules in place governing the number of pharmacies that can operate in a given area based on the number of people there, as well as around transfer of ownership, which is often passed down from one generation to the next within the same family.

These tight controls are the result of a powerful pharmacists’ lobby that raises strong objections whenever attempts are made to liberalise the sector.

Many Italian industry associations are similarly powerful: Italy’s taxi drivers’ unions, for example, are why the country still doesn’t have standard Uber (the luxury Uber Black is currently the only private car ride-hailing service on offer, though you can use the app to summon and pay for a cab in some cities).

READ ALSO: Reader question: Why can’t I get an Uber in Italy?

Meanwhile groups representing the managers of Italy’s lucrative ‘private’ beach clubs on public land have repeatedly managed to pressure the government to push back the deadline for implementing an EU directive designed to make the concessions tender process more transparent.

This all means that Italy’s pharmacies have a huge amount of control when it comes to setting prices for basic medicines, as almost nowhere else can sell them.

In 2007 Italy did pass a law that meant some basic over-the-counter drugs could be sold outside pharmacies for the first time, and a 2012 decree increased the number of drugs that could be sold in those venues without a prescription.

But the parafarmacie or ‘parapharmacies’ – basically health and beauty stores – where these drugs can be sold must still be manned by a trained pharmacist, and the same goes for drug counters in supermarkets, which are few and far between.

If you want to exercise limited some control over price, make sure to always ask for la versione generica (the generic version) of whatever medicine you’re buying: pharmacists will usually offer you the more expensive branded version in the first instance as it means a higher cut for them.

Failing that, you can bring a certain amount of some medicines back from your home country in your suitcase – so it may be worth stocking up the next time you’re back.