Access to medicine is a central component of the right to health. Exponential increases in the price of medicines and the emergence of high-priced innovative therapies on the market have put the sustainability of the system at risk. For this reason, the province of Buenos Aires (Argentina) changed its drug policy from historically decentralized management by each health care provider to a policy based on centralized procurement, integrated processes, increased public production of medicines, and the development of information systems. This article compares both management models (decentralized versus centralized and integrated) in terms of economics and access. Implementation of a centralized and integrated policy quadrupled the public production of essential medicines, increased access to medicines for registered users by 1 071.2%, improved the capacity to monitor traceability, and generated savings of 27.18% per unit in the procurement of pharmaceuticals compared to the usual mechanism of decentralized procurement by hospitals. In terms of impact, US$ 32 590 645.66 was saved, based on demand. Centralized and integrated management of drug procurement, production, storage, and distribution resulted in significant reductions in purchase prices, improved distribution, and optimized drug traceability compared to decentralized management models.