ISLAMABAD: At least 80 important medicines are not available in Pakistan, including 25 which have no substitutes, creating serious problems for patients suffering from diabetes, cancer, Alzheimer’s, Parkinson’s, psychiatric illness, heart disease and for children needing vaccines.
Doctors and pharmacists say the shortage of most-prescribed brands is now a health emergency as many patients cannot continue their treatment. Among the medicines with no alternatives is a long-acting injectable insulin for diabetics is missing from the market. Its absence is leading to uncontrolled blood sugar and an increased risk of kidney failure, blindness and amputations. Similarly, hormonal drugs for hormone replacement therapy and injection for testosterone deficiency in men are also not available.
Pharmacists interviewed by this scribe said cancer and transplant patients are badly affected because a life-saving antifungal drug has not been available for eight months. Without it, patients are exposed to dangerous fungal infections.
Diagnostic tests are also affected because injectable contrast agents used in MRI and CT scans, are not available. Doctors say this means cancers, brain conditions and blood vessel problems cannot be properly diagnosed.
Leading neurologists claimed that neurology patients are facing great hardship as memantine hydrochlorids, a drug for Alzheimer’s disease, and eszopiclone , used in psychiatric disorders, are no longer available. Oxcarbazepine, a drug also used in Parkinson’s and neurological disorders, is short, and so is alprozolam, which is commonly prescribed for anxiety and panic. Neurologists say Parkinson’s patients are suffering tremors and rigidity because their medicines have stopped.
Heart patients are also suffering because metoprolol tartrate , rivaroxaban, a blood thinner to prevent clots and strokes, and nifedipine for blood pressure are not available. Doctors say switching to other medicines can increase the risk of stroke, heart attack and sudden death. Even ibuprofen 400/600mg, once the most common painkiller, is not available. Children are badly hit as the meningitis vaccine has not been available for over a year. This is putting thousands of children at risk of brain infections and death. Even a simple vitamin C syrup and tablet is not on pharmacy shelves.
Pharmacists said sustained-release tolterodine tartrate for bladder problems has been unavailable for more than a year, leaving elderly patients in distress. Acarbose, a diabetes drug, has not been available for a year, while chlorphenamine maleate, a common anti-allergy medicine, is short. Eye patients cannot find some lubricating drops of gel.
Patients suffering from pain and autoimmune disorders are facing problems due to shortages of methylpresdnisolone intramuscular injection and piroxicam. Both are widely used but not available. In addition to these, 46 other medicines are short even though substitutes exist.
Pharmaceutical distributors admit some of these shortages have continued for more than a year. They said multinational companies have reduced or stopped manufacturing several medicines. They argue that government price controls have made it commercially unfeasible to produce low-cost drugs, while local manufacturers do not have the capacity or technology to produce injectables, vaccines or neurological medicines.
The shortage has led to black market profiteering. A vial of insulin that should cost Rs1,200 is selling for Rs4,000 if available at all. Many families cannot afford this. Pharmacists and doctors say patients missing their medicines are already facing complications.
Tauqeerul Haq, chairman of the Pakistan Pharmaceutical Manufacturers Association (PPMA), warned that the government indecision has worsened the crisis. He said the federal cabinet recently rejected the fixation of prices for 35 new essential medicines that the DRAP had forwarded after fulfilling all regulatory requirements.
“This rejection means more medicines will disappear from shelves because manufacturers cannot sustain losses. Patients will be the ultimate sufferers,” he said, urging the government to take pragmatic decisions instead of delaying policy reforms.
The Drug Regulatory Authority of Pakistan (DRAP), however, downplayed the crisis, saying ‘a few shortages’ are largely the result of international supply chain disruptions, increased input costs, and reduced production by several manufacturers. “We are working in close coordination with all stakeholders to ensure availability of medicines. Emergency import permissions are being given where necessary, while efforts are underway to enhance local production capacity,” the regulator said, adding that it is monitoring the situation continuously and expects a gradual improvement in supply once global raw material and logistical challenges stabilize.
Published in The News on August 28, 2025.
