KARACHI: A large number of patients and their families are facing hardship in finding several essential medicines, including advanced cancer therapies, vaccines and other life-saving treatments, which are either currently unavailable or in short supply at the retail level, according to healthcare professionals, medicine traders and pharmaceutical industry sources.

Industry sources said that the recent shortage is not due to the ongoing war in the region but rather because of the country’s policy matters. Most imported medicines and their raw materials in Pakistan come from China, which remains commercially active, they added.

“In fact, if you do not resolve the issue of price fixation for a medicine, then why would manufacturers and suppliers provide that medicine? They know that supplying medicines whose prices have not been officially fixed could bring them under the regulator’s scrutiny. As a result, in such a situation, counterfeit products begin to take the place of those medicines as substitutes. This is dangerous both for human lives and for the trader,” an industrialist said.

The unavailability has raised concerns among patients and doctors, who say access to critical treatments has become increasingly difficult not only in Karachi but also in many parts of the country. They refer to several modern anti-cancer therapies, including nivolumab, pembrolizumab and nilotinib hydrochloride, which are widely used internationally for the treatment of various cancers, including leukaemia and other advanced malignancies.

Industry sources blame bureaucratic red tape, not Iran war, for crisis

“These medicines are now considered standard treatments in many cancers around the world. When they are not available through regulated channels in the country, patients are deprived of modern therapies that can significantly improve survival and quality of life,” said Dr Hira Ahmed, a senior oncologist.

The medicine market sources said that other medicines affected include tacrolimus hydrochloride, an immunosuppressant used to prevent organ transplant rejection, and verapamil hydrochloride, which is used in cardiac therapy. Several vaccines are also facing the same situation, including the Typhoid Vi polysaccharide vaccine, poliomyelitis vaccine, pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine used to prevent serious bacterial infections.

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 affected.

Medicines used for chronic diseases are also affected, they said. These include semaglutide injection, used for obesity and diabetes management and adalimumab, which is widely used in autoimmune disorders and some oncology indications.

The industry sources said that the shortages are largely linked to delays in the official notification of prices for these medicines. Although recommendations have already been submitted by the Drug Regulatory Authority of Pakistan (Drap), the federal government has yet to formally notify their prices.

As a result, several advanced therapies, vaccines and other critical treatments cannot be introduced or supplied in the market, contributing to their current unavailability.

The industry officials say the issue is not related to an increase in medicine prices but rather the fixation of prices for new medicines so they can be legally marketed in Pakistan.

“Without official price notification, companies cannot import or supply these medicines in the country even if they are internationally approved and urgently needed by patients,” a pharma industrialist said.

He warned that such delays often create space for informal markets where medicines may enter through smuggled or unregulated channels. When medicines are unavailable through regulated supply chains, patients start searching for them in the grey market, where the risk of substandard or counterfeit products increases, he added.

Abdul Samad Budhani of the Pakistan Chemists and Druggists Association said the government’s hesitation in fixing prices of essential medicines, vaccines and biological products had become a serious problem for patients.

“Patients are asking for these medicines and demanding brands that are not registered in Pakistan. 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,” he added.

Published in Dawn, March 12th, 2026