Islamabad: Thousands of patients in Pakistan are being deprived of modern medicines and immunotherapies and are forced to rely on conventional chemotherapy or extremely costly imported medicines as the federal government has delayed fixation and notification of prices of several essential drugs for the last many months, healthcare professionals and pharmaceutical industry officials said.
They say the delay has prevented the local availability and legal marketing of a number of modern medicines including advanced cancer therapies, transplant drugs, vaccines and other life-saving treatments despite the fact that their prices have already been recommended by the Drug Regulatory Authority of Pakistan (DRAP).
Among the medicines awaiting price notification are several widely used cancer therapies including nivolumab, pembrolizumab and nilotinib hydrochloride, which have become standard treatments globally for multiple cancers including melanoma, lung cancer and certain forms of leukemia.
These medicines belong to a class of immunotherapy drugs that help the immune system identify and attack cancer cells and have significantly improved survival rates for many patients.
Doctors say that without access to such therapies many patients in Pakistan are still dependent on older chemotherapy regimens which are often less effective and associated with greater side effects.
“These medicines are now considered standard treatment in many cancers around the world,” said Dr Hira Ahmed, a senior oncologist at a tertiary care hospital. “When they are not available through regulated channels in Pakistan, patients are deprived of therapies that can significantly improve survival and quality of life.”
Other medicines awaiting notification include tacrolimus hydrochloride, an immunosuppressant widely used to prevent rejection in organ transplant patients, and verapamil hydrochloride, a medicine commonly used in cardiac therapy.
Several vaccines that protect against serious infectious diseases are also awaiting price notification including the Typhoid Vi polysaccharide vaccine, poliomyelitis vaccine, pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine, which are used to prevent invasive bacterial infections and other potentially life threatening illnesses.
In addition, human rabies immunoglobulin used for rabies exposure, recombinant human coagulation factor VIII used in haemophilia treatment and the anti malaria combination pyronaridine plus artesunate are also awaiting official price fixation.
Experts say medicines used in chronic diseases are also affected. These include semaglutide injection used for obesity and diabetes management and adalimumab, which is widely used in autoimmune disorders such as rheumatoid arthritis as well as certain cancer related indications.
Pharmaceutical industry officials say the issue is not related to increasing medicine prices but rather the delay in fixation of prices for new medicines which is required before they can be legally marketed in Pakistan.
“Without official price notification companies cannot import, manufacture or supply these medicines in the country even if they are internationally approved and urgently needed by patients,” a senior pharmaceutical industry official said.
They warn that prolonged delays often push desperate patients toward informal channels where medicines may enter the market through smuggling or unregulated supply chains.
“When medicines are not available through legal channels, the risk of substandard or counterfeit products increases because patients start searching for them through the grey market,” the official said.
Chairman Pakistan Chemists and Druggists Association Abdul Samad Budhani said the government’s hesitation in fixing prices of essential medicines, vaccines and biological products had become a serious issue for patients.
“Patients are asking for these medicines and demanding brands which are not registered in Pakistan,” he said. “This situation is encouraging the production and circulation of counterfeit and falsified medicines in the country and is putting hundreds of precious lives at risk.”
Industry representatives say the delay is also affecting Pakistan’s pharmaceutical export potential because many importing countries require that a medicine be registered and marketed in its country of origin before granting approval for import.
According to officials, the prices of several medicines were finalised during the 62nd meeting of the Drug Pricing Committee in December 2024, while another DPC meeting held on December 7, 2025 also approved pricing decisions that are still awaiting notification.
Officials at DRAP confirmed that the regulatory review process for these medicines had already been completed.
“The pricing proposals have passed through the Drug Pricing Committee and the DRAP Policy Board,” a DRAP official said. “The issuance of SROs by the federal government is now required so that these medicines can be legally marketed in Pakistan.”
Healthcare professionals and pharmaceutical industry representatives have urged the federal government to expedite the notification of pending price decisions, warning that continued delays are depriving patients of modern therapies and weakening access to essential medicines in the country.
Ends