AVAILABILITY AND PRICES OF LOCALLY PRODUCED AND IMPORTED ANTI-CANCER MEDICINES IN PAKISTAN
Author(s)
Sundus Shukar, Pharm-D, MSc1, Inzemam Khan2, Imran Qureshi3, Samama Hameed4, Zaheer-Ud-Din Babar5, Caijun Yang6, Yu Fang6.
1Regional Research Coordinator, Xi'an JiaoTong University, Xi'an, China, 2University of Peshawar Kpk Pakistan, Pakistan, 3Ziauddin Hospital, Pakistan, Pakistan, 4GlaxoSmithKlein, Pakistan, 5Qatar, 6Xi'an Jiaotong University, Xi'an, China.
1Regional Research Coordinator, Xi'an JiaoTong University, Xi'an, China, 2University of Peshawar Kpk Pakistan, Pakistan, 3Ziauddin Hospital, Pakistan, Pakistan, 4GlaxoSmithKlein, Pakistan, 5Qatar, 6Xi'an Jiaotong University, Xi'an, China.
OBJECTIVES: Local pharmaceutical production is increasingly promoted as a strategy to improve access to essential medicines. Pakistan has substantial domestic pharmaceutical manufacturing capacity and has included all WHO-recommended anti-cancer medicines in its national essential medicines list, yet access gaps persist. This study assessed whether locally produced anti-cancer medicines improve availability and patient prices compared with imported products in Pakistan.
METHODS: A cross-sectional stock-level survey was conducted using an adapted WHO/Health Action International local-versus-imported medicine survey approach. Data were collected from 26 outlets across five major regions. Surveyed sectors included public hospitals, private hospitals, NGO-based hospitals, and retail pharmacies. The study assessed 67 anti-cancer medicines from the 2023 WHO Model List of Essential Medicines. Products were classified as locally produced if manufactured in Pakistan and imported if manufactured outside Pakistan. Median unit prices were calculated overall, by sector, and by source of supply.
RESULTS: Overall availability of selected anti-cancer medicines was 49.5%. Locally produced products were available in 30.7% of observations, compared with 26.6% for imported products. Availability was highest in private hospitals, followed by NGO-based hospitals, public hospitals, and retail pharmacies. Locally produced products were more readily available in private hospitals and retail pharmacies, while imported products were slightly more available in public hospitals. The overall median unit price was USD 4.36. In unpaired analysis, imported medicines had a higher median unit price than locally produced medicines overall, particularly in public hospitals, private hospitals, and retail pharmacies. Paired comparisons showed imported products were consistently more expensive in public hospitals and retail pharmacies, while price differences in private hospitals varied by medicine.
CONCLUSIONS: Local production contributed to the anti-cancer medicines' availability in Pakistan, but did not ensure consistent sector-wide access or universal price advantages. Manufacturing capacity alone is insufficient to improve patient access unless supported by effective procurement, price regulation, mark-up control, and supply-chain policies.
METHODS: A cross-sectional stock-level survey was conducted using an adapted WHO/Health Action International local-versus-imported medicine survey approach. Data were collected from 26 outlets across five major regions. Surveyed sectors included public hospitals, private hospitals, NGO-based hospitals, and retail pharmacies. The study assessed 67 anti-cancer medicines from the 2023 WHO Model List of Essential Medicines. Products were classified as locally produced if manufactured in Pakistan and imported if manufactured outside Pakistan. Median unit prices were calculated overall, by sector, and by source of supply.
RESULTS: Overall availability of selected anti-cancer medicines was 49.5%. Locally produced products were available in 30.7% of observations, compared with 26.6% for imported products. Availability was highest in private hospitals, followed by NGO-based hospitals, public hospitals, and retail pharmacies. Locally produced products were more readily available in private hospitals and retail pharmacies, while imported products were slightly more available in public hospitals. The overall median unit price was USD 4.36. In unpaired analysis, imported medicines had a higher median unit price than locally produced medicines overall, particularly in public hospitals, private hospitals, and retail pharmacies. Paired comparisons showed imported products were consistently more expensive in public hospitals and retail pharmacies, while price differences in private hospitals varied by medicine.
CONCLUSIONS: Local production contributed to the anti-cancer medicines' availability in Pakistan, but did not ensure consistent sector-wide access or universal price advantages. Manufacturing capacity alone is insufficient to improve patient access unless supported by effective procurement, price regulation, mark-up control, and supply-chain policies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR187
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Health Disparities & Equity, Pricing Policy & Schemes, Procurement Systems, Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology