Pakistan is experiencing a critical shortage of more than 100 essential medicines after a prolonged delay in approving revised drug prices, raising concerns over patient safety and the growing risk of counterfeit medicines entering the market.
The Drug Regulatory Authority of Pakistan (DRAP) recommended revised prices for 105 hardship-category medicines more than two years ago after concluding that rising production costs had made their manufacture commercially unsustainable. However, the proposals remain pending before the federal cabinet, delaying a final decision and disrupting the supply of several life-saving drugs.
Rising costs make production unviable
According to DRAP’s Drug Pricing Committee, pharmaceutical manufacturers have been hit by sharp increases in the cost of imported raw materials, electricity, fuel, packaging, transportation, labor, financing, and the depreciation of the Pakistani rupee.
The committee determined that these factors have significantly increased production costs, making it financially difficult for companies to continue manufacturing several essential medicines under existing government-approved prices.
As a result, a number of pharmaceutical companies have either scaled back production or completely discontinued the manufacture of certain medicines, contributing to widespread shortages across the country.
Cancer and heart medicines among those affected
Health sector representatives say the shortage includes medicines used to treat cancer, cardiovascular diseases, infectious illnesses, and other serious medical conditions.
According to Abdul Samad Buddani, a representative of the Pakistan Chemists and Druggists Association (PCDA), around 105 medicines are currently unavailable or in critically short supply.
The affected medicines include:
- Oral morphine for severe cancer pain
- Streptokinase injections for heart attack treatment
- Chemotherapy medicines including cisplatin, carboplatin, and doxorubicin
- Pediatric digoxin
- Pilocarpine eye drops
- Yellow fever vaccine
- Folic acid tablets
- Several immunoglobulin products
Healthcare professionals warn that prolonged shortages of these medicines could adversely affect treatment outcomes for thousands of patients.
Counterfeit medicine risk grows
Industry stakeholders caution that persistent shortages are creating opportunities for counterfeit and substandard medicines to enter the supply chain.
They warn that patients searching for hard-to-find medicines—particularly expensive cancer drugs and other life-saving treatments—may unknowingly purchase fake or poor-quality products from unauthorized suppliers, posing serious health risks.
The pharmaceutical industry has urged authorities to act quickly, arguing that the hardship pricing mechanism exists specifically to ensure the continued availability of essential medicines when production becomes commercially unviable.
DRAP says cabinet approval is pending
Officials at DRAP confirmed that the authority completed its review and forwarded the pricing recommendations to the government in February 2024.
According to DRAP Chief Executive Officer Dr Obaidullah Malik, the matter now rests with the federal cabinet, which must decide whether to approve the proposed price revisions.
Until a decision is made, manufacturers say shortages are likely to persist, potentially placing additional pressure on Pakistan’s healthcare system and increasing the risk of further supply disruptions.
