Manuka vs regular honey — when the 10× price is worth it, and when it isn't

The first thing to say is that regular honey is not useless on a wound. Every honey delivers four mechanisms that matter clinically: an osmotic gradient that pulls fluid out of the tissue, a low pH that supports healing, a moist environment that protects granulation, and — in most honeys — hydrogen peroxide generated as glucose oxidase meets wound fluid. Buckwheat, Heather, and even a properly processed multifloral can be a perfectly adequate moist wound dressing.

What Manuka adds is methylglyoxal: a non-peroxide, heat-stable, catalase-resistant antibacterial that survives the wound environment and the sterilisation cycle. That is real chemistry — but you do not always need it.

When Manuka is worth the 10× price

• Sterilised, single-use dressings. The product has to come off the production line sterile and stay active for two years. Peroxide activity is partly lost to gamma; MGO is not.
• Wounds with high catalase load. Infected, exudating or chronic wounds carry catalase from host cells and from bacteria. Catalase destroys hydrogen peroxide on contact. MGO is unaffected.
• Antimicrobial-resistant indications. MGO has documented activity against MRSA, VRE and biofilm communities where peroxide-only honeys have inconsistent results.
• Regulated claims. A medical-device dossier needs a dose-quantified active. "Total antibacterial activity" is hard to defend; mg/kg MGO is straightforward.

When a cheaper honey is the right answer

• Bulk debridement on uncomplicated wounds. The osmotic effect is the same whether the honey costs $5/kg or $80/kg.
• Veterinary topical use on clean lesions. Equine and livestock applications often run on peroxide-active multiflorals for cost reasons, with good outcomes.
• OTC consumer skin and throat products where the role is soothing and moisturising rather than antibacterial.
• Food-grade and culinary use — Manuka delivers no additional culinary value.

The price reality

A wholesale food-grade multifloral runs $4–8 per kilogram. A wholesale MGO 263+ Manuka runs $40–80 per kilogram. A wholesale MGO 829+ medical-grade Manuka can run $150–250+ per kilogram. The 10–30× multiplier is real and reflects scarcity, NZ-only origin, and testing overhead — not margin alone.

If your product needs the chemistry, pay for it. If it does not, pick the honey that delivers the mechanism you actually use.