• Federal cabinet yet to decide on proposals despite Drap recommending price revisions for 105 hardship-category medicines over two years ago
• Prolonged shortages creating opportunities for illegal suppliers to fill the gap, chemists’ body warns

KARACHI: The prolonged shortage of more than 100 essential medicines, including life-saving drugs for cancer, heart disease and other serious illnesses, has created space for counterfeit and substandard products, as the federal government continues to delay, for more than two years, a decision on revising prices that manufacturers say no longer cover production costs, market sources and officials said on Friday.

At the heart of the crisis, they said, was the prolonged delay in deciding the prices of essential medicines.

More than two years after the Drug Regulatory Authority of Pakistan (Drap) recommended price revisions for 105 hardship-category medicines, the federal government has yet to approve the proposals.

Drap’s drug pricing committee concluded that the rising costs of imported raw materials, energy, packaging, transportation, labour, financing and currency depreciation had made the production of many essential medicines commercially unviable.

However, with the recommendations still pending before the federal cabinet, several manufacturers have either scaled back or suspended production, worsening the shortage of critical medicines across the country.

Abdul Samad Buddani of the Pakistan Chemists and Druggists Association (PCDA) warned that prolonged shortages of genuine medicines were creating opportunities for counterfeiters and illegal suppliers to fill the gap.

“A total of 105 medicines are either unavailable or in critically short supply. They include oral morphine capsules in both 10mg and 30mg strengths used for severe cancer pain, streptokinase injections for heart attacks, chemotherapy medicines including cisplatin, carboplatin and doxorubicin, paediatric digoxin liquid, pilocarpine eye drops, yellow fever vaccine, folic acid tablets and several immunoglobulin products,” he said.

The growing shortage has also raised concerns about the integrity of the pharmaceutical supply chain, with industry representatives warning that the prolonged unavailability of genuine medicines is creating opportunities for counterfeit and substandard products to fill the gap.

“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,” Mr Buddani said.

‘Financially unsustainable’

Pharmaceutical manufacturers claim that the shortages are largely the result of prolonged delays in implementing the hardship pricing mechanism, arguing that the current pricing structure has made the production of several essential medicines financially unsustainable.

They urged the government to expedite pending decisions to restore supplies and prevent further disruptions.

A senior member of the Pakistan Pharmaceutical Manufacturers’ Association (PPMA) said successive governments had delayed decisions on hardship-category medicines despite clear recommendations from the Drug Pricing Committee, discouraging manufacturers from continuing the production of several essential medicines.

“If manufacturers cannot recover even the basic cost of producing essential medicines, production simply cannot continue. The pricing policy exists to ensure these medicines remain available to patients, and timely decisions are necessary to achieve that objective,” he said.

Officials at Drap confirmed that the cases have remained pending since February 2024 despite recommendations by the Drug Pricing Committee, which concluded that manufacturing many essential medicines had become commercially unviable under existing prices.

“The regulatory authority has completed its mandate by processing the applications and forwarding its recommendations to the government. The final decision rests with the federal cabinet, which has to determine the matter in the broader public interest,” Drap Chief Executive Officer Dr Obaidullah Malik said in a brief reply to Dawn’s query.

Published in Dawn, July 13th, 2026