Pricing Delay Risks Shortage of 100+ Life-Saving Medicines

The federal government’s failure to approve price revisions for more than two years has triggered a crippling shortage of over 100 essential medicines, forcing cancer and heart patients to scramble for alternatives while counterfeiters rush to fill the void.

At the centre of the crisis sits a stalled decision. The Drug Regulatory Authority of Pakistan (DRAP) recommended price revisions for 105 hardship-category medicines after its drug pricing committee concluded that soaring costs of imported raw materials, energy, packaging, transportation, labour, financing, and currency depreciation had rendered production commercially unviable. Yet the proposals have gathered dust before the federal cabinet since February 2024.

With manufacturers unable to recover even basic production costs, several have either scaled back or halted output entirely. The result: critical drugs have disappeared from the market.

Among the medicines now unavailable or in critically short supply are oral morphine capsules in 10mg and 30mg strengths for severe cancer pain, streptokinase injections for heart attacks, chemotherapy drugs including cisplatin, carboplatin, and doxorubicin, paediatric digoxin liquid, pilocarpine eye drops, yellow fever vaccine, folic acid tablets, and several immunoglobulin products.

Abdul Samad Buddani of the Pakistan Chemists and Druggists Association (PCDA) warned that the prolonged absence of genuine medicines has opened the door for counterfeiters and illegal suppliers.

“When authentic medicines disappear from the market, patients become desperate and often turn to unreliable sources. That increases the risk of counterfeit and substandard medicines entering the supply chain, particularly expensive cancer medicines and other life-saving drugs,” he said.

A senior member of the Pakistan Pharmaceutical Manufacturers’ Association (PPMA) echoed the frustration, stating that successive governments have delayed decisions on hardship-category medicines despite clear recommendations from the Drug Pricing Committee.

“If manufacturers cannot recover even the basic cost of producing essential medicines, production simply cannot continue,” he said.

DRAP CEO Dr. Obaidullah Malik confirmed that the regulator has completed its mandate by processing the applications and forwarding recommendations to the government. “The final decision rests with the federal cabinet, which has to determine the matter in the broader public interest,” he told Dawn.