ISLAMABAD: Hundreds of thousands of patients with cancer, heart disease, glaucoma and other life-threatening illnesses are facing severe hardship as shortages of several essential medicines have worsened across Pakistan.
The crisis follows the federal government’s failure to decide on recommended price increases for 105 hardship-category medicines for more than two and a half years, forcing many manufacturers to halt production.
Among the medicines either unavailable or in critically short supply are oral morphine capsules (10mg and 30mg) for severe cancer pain, streptokinase injections for heart attacks, chemotherapy medicines including cisplatin, carboplatin and doxorubicin, pediatric digoxin liquid, pilocarpine eye drops, yellow fever vaccine, active form of folic acid required for “folinic rescue” after chemotherapy to reverse bone marrow suppression and several immunoglobulin products, according to pharmaceutical industry officials and DRAP sources.
Officials of the Drug Regulatory Authority of Pakistan (DRAP) confirmed that prices of 105 hardship-category medicines have remained pending since February 2024 despite recommendations by the Drug Pricing Committee.
The officials familiar with the process said the committee found production of several essential medicines commercially unviable because of soaring manufacturing costs and recommended price adjustments under the Drug Pricing Policy. The cases were subsequently forwarded through the Ministry of National Health Services, Regulations and Coordination to the federal cabinet.
However, despite the passage of more than two and a half years, no final decision has been taken, leaving manufacturers unwilling or unable to continue producing many of these medicines.
A senior DRAP official, requesting anonymity because he was not authorised to speak publicly, acknowledged shortages of several medicines but maintained that the DRAP had completed its regulatory responsibility.
“The cases were processed under the policy and recommendations were forwarded to the government. The final decision rests with the federal cabinet and the government has to decide in what it considers the larger public interest,” the official said.
Ophthalmologists have also warned about shortages of pilocarpine eye drops used in glaucoma and emergency eye conditions, while cardiologists describe streptokinase as a life-saving clot-dissolving medicine for heart attack patients, particularly where more expensive alternatives are unavailable.
Abdul Samad, chairman of the Pakistan Chemists and Druggists Association (PCDA), said that the prolonged failure to revise prices of essential medicines was creating a vacuum increasingly being filled by counterfeit and spurious drugs, including cancer medicines and other life-saving products.
Officials of the Pakistan Pharmaceutical Manufacturers’ Association (PPMA) urged the federal government to immediately approve DRAP recommendations for all 105 medicines so manufacturers could resume production.
