nflation has reached an all-time high in Pakistan. The worsening economic situation has left many middle- and low-income households struggling. With an increase in essential drug prices, the situation has become trickier for those in need of regular medication to manage health issues. Since the authorities announced a raise in medicine prices, Ahmed Ali, a 55-year-old mid-level private organisation employee, has been worried. He needs to buy medicines monthly for his diabetic wife and two sons who have Parkinson’s disease.

“I’m a heart patient and need medicines daily. My wife is diabetic. She and my two sons also have Parkinson’s disease. I must spend around Rs 25,000 from my meagre salary on medicines. At a time when the cost of fuel, electricity and gas is constantly rising, this hike in the prices of medicines could prove the proverbial last straw for a financially over-burdened person,” Ahmed Ali says.

Under pressure from the pharmaceutical businesses, both local as well as multinational, the Economic Coordination Committee (ECC) of the federal cabinet last week announced a raise in the prices of essential medicines by up to 14 percent and up to 20 percent for non-essential medicines registered in Pakistan. Once implemented, this will mark a 30 percent raise in the prices of non-essential medicines in two years. Last year, a 10 percent hike was allowed in the prices of non-essential medicines and a 7 percent raise in the prices of essential medicines.

According to the Drug Regulatory Authority of Pakistan (DRAP), the total pharmaceutical market size in Pakistan was estimated to be around Rs 350 billion (approximately $2.2 billion) in 2019. This includes all types of medicines, ranging from over-the-counter to prescription drugs.

“The amount of medicine consumed in Pakistan each year can be difficult to estimate. However, it is safe to say that millions of people in the country rely on medication to manage various health conditions and illnesses. There is a growing demand for healthcare services in Pakistan. With a population of more than 220 million people, the need for medicines is likely to continue to rise in the coming years,” says Abdus Samad Budhani, a medicine dealer and a member of the Pakistan Chemists and Druggists Association (PCDA).

There are around 33 million people living with diabetes in Pakistan. Around 50 million people regularly take medicines for the treatment of cardiovascular disease, hypertension, psychiatric illnesses and neurological disorders, cancers and several other non-communicable diseases.

Experts say that several million people don’t take medicines regularly because they cannot afford them with their limited income.

There are around 33 million people living with diabetes in Pakistan and around 50 million people regularly take medicines for the treatment of cardiovascular disease, hypertension, psychiatric illnesses and neurological disorders, cancers and other non-communicable diseases. Experts say that several million people don’t take medicines regularly as they cannot afford them with their limited incomes. 

Budhani says people who need medicines regularly should switch to generic drugs as they are cheaper than branded medicines but equally effective in controlling and managing diseases.

“People should switch to generics, which are significantly cheaper than branded medicines. Pharmacies can help patients get cheap medicines”, he says, adding that task forces should be formed to ensure that budgets reserved for free medicines are properly spent and the poor regularly get the required medicines from the public health medicine stores.

Prof Shahzad Ali Khan, a public health expert, says healthcare expenditure can be reduced by ethical prescription of medicines by healthcare practitioners. In many cases, he says, unnecessary medicines are prescribed to the patients.

“Yesterday, I saw a prescription where a medical practitioner had prescribed an antibiotic produced by two pharmaceutical companies. The patient had been prescribed ciprofloxacin from two companies in half doses. Such practices only burden the patients while corrupt healthcare practitioners and pharmaceutical companies benefit at their cost,” he says.

According to him, healthcare expenses could be brought down to 10 percent by switching to lifestyle medicines, including traditional Chinese medicines, Ayurvedic and Unani medicines which are more affordable than allopathic drugs but call for learning from the experiences of China, India, Germany and some Far Eastern countries where such alternate systems of medical treatment are practiced.

Pakistan Pharmaceutical Manufacturers Association (PPMA) is not satisfied with the announced raise in the prices of medicines. It says it had been demanding a 39 percent raise in the prices of medicines due to a 40 percent hike in the Consumer Price Index (CPI). Instead, only a 20 percent raise was allowed by the government.

“Several hundred medicines had vanished from the market as their production was no more financially viable… The patients were suffering and forced to buy expensive smuggled medicines. This 20 percent raise in the prices of medicines will help the pharmaceutical companies resume production of the medicines that have not been available in the market for several months”, says Syed Farooq Bukhari, the PPMA chairman.

But Ahmed Ali and millions of others like him are worried and unsure how to manage essential drug supply for themselves and their families.

“I can’t cut my spending on medicines… If something happens to me; there is nobody to earn bread and butter for my family. I can’t cut the medicines for my wife and children either. This has become a constant agony and mental burden for me,” he says.

The writer is an investigative reporter, currently covering health, science, environment and water issues for The News International