Conventional wastewater treatment lacks the ability to remove many pharmaceuticals. This is leading to emissions to the natural aquatic environment, where these compounds pose a risk to the aquatic organisms. An advanced wastewater treatment technique that has shown promising results is Moving Bed Biofilm Reactors (MBBR). Initial degradation velocity and degradation rate constants of the pharmaceuticals are important parameters for designing an optimal MBBR system; however, the degradation efficiency varies across studies and one of the most plausible causes might be initial concentration. Thus, to verify the effect of initial concentration, the degradation of a mixture of 18 pharmaceuticals at different initial concentrations was studied. For this study MBBR's with very low BOD loading were used as they were conditioned with effluent water. The experiment was set up as a MBBR batch incubation, using effluent wastewater as medium, spiked with the 18 pharmaceuticals in seven different concentration levels (approximately 0–300 µg L−1). The degradation of 14 out of 18 pharmaceuticals was concentration-dependent. The initial degradation velocity of the pharmaceuticals was either proportional to the initial concentration or was following a typical Michaelis-Menten kinetic. The degradation velocity of one compound, i.e., sulfamethizole might have been inhibited at high concentrations. The degradation rate constants from single first-order fittings (KSFO) for some compounds deviated from the expected behavior at low concentrations (below 10 µg L−1). This is suggested to be caused by simplicity of the Michaelis-Menten model, not taking possible occurrence of co-metabolism and mass-transfer limitations into account at low concentrations. This study underlines the fact that K values cannot be interpreted without paying attention to the tested concentration level. Furthermore, it shows that the used MBBRs was able to handle high concentrations of pharmaceuticals, and that the most efficient removal occurs at concentrations above 100 µg L−1.