World Cancer Day 2023: Pakistan facing acute shortage of anti-cancer, therapy drugs

ISLAMABAD: At a time when the entire world is observing World Cancer Day 2023 today, healthcare facilities treating cancer patients are facing an extreme shortage of several important chemotherapy drugs and medicines used for the treatment of breast, prostate cancers as well as leukaemia, lymphoma, neuroblastoma, sarcoma, and Wilms’ tumour (the most common type of kidney cancer in children), officials and oncologists told The News on Friday.

In addition to chemotherapy drugs and anti-cancer medicines, several other essential medicines including drugs for the treatment of tuberculosis, and psychiatric illnesses, immunosuppressants, antivirals for the prevention of various viral illnesses, anaesthetics to make patients unconscious for surgeries, blood-thinning agents and many other life-saving drugs are not available to the health facilities for the highly sick patients.

“Yes many cancer therapies are not available at the moment in the country and one of the major issues in the shortage of essential cancer therapies is the delay in the LCs. Anticancer drugs are imported in ready-to-use form and are difficult to import due to LC restrictions”, says Dr Faisal Sultan, Chief Executive Officer (CEO) of the country’s largest cancer treatment facility Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC) Lahore.

He said suppliers’ stock of anticancer medicines, chemotherapy drugs and biological products is getting low and they are facing difficulties in maintaining required inventories. “Anticancer drugs that are manufactured within the country are also affected due to the non-availability of raw materials (due to import issues). As per PPMA, they are left with a few days’ inventories of raw materials in the country”, Dr. Faisal Sultan added that the impact of such restrictions on imports will create severe shortages of essential chemotherapy medicines in the upcoming months. “This will also impact the other basic essential medications used for minor ailments and as supportive therapies for cancer patients. Shortages may further lead to overpricing (via illegal channels) once the market dries up for legitimate sources”, he added.

Officials of leading private health facilities in Islamabad also expressed similar apprehensions, saying they were facing problems in getting essential anticancer medicines for the treatment of breast cancer, which is the most common cancer among women and adding that in addition to anticancer medicines, several other essential medicines including antibiotics, antipsychotic drugs, anaesthetics and others were also not available in the market for the treatment of sick patients. “We have written a letter to the Drug Regulatory Authority of Pakistan (DRAP), pointing out that around 21 essential and life-saving medicines are not available in the market and unfortunately, alternate brands of these medicines are also available in the market”, Salwa Ahsan, a leading pharmacist and head of the pharmacy at a leading private health facility in Islamabad said.

According to her, the most important drugs not available to them were “Epirubicin, Doxorubicin and BCG Oncotice”, which are anticancer medicines which are used for the treatment of breast cancer, leukaemia, lymphoma, neuroblastoma, sarcoma, and Wilms’ tumour (the most common type of kidney cancer in children) as well as for the treatment of bladder cancer. She maintained that in addition to cancer medicines, they were also facing extreme difficulties in acquiring treatment for TB, which is the spreading life fire in Pakistan, antipsychotic drugs, essential anaesthetics, painkillers and antiviral medicines. “We have requested the DRAP to ensure registration of alternate brands of several essential medicines on the fast track so that physicians and healthcare facilities had the alternative therapies available. At the moment, most of the essential medicines have no alternate brands available”, she added.

Several other physicians and pharmacists at leading public and private hospitals said they were also facing a shortage of essential medicines including anticancer therapies, drugs for the prevention and treatment of cardiovascular diseases, stroke medicines as well as those used for the treatment of psychiatric illnesses. According to them, another important drug that was not available in the country was Diphtheria Antitoxin, which is used for the treatment of Diphtheria, saying it was a life-saving drug but currently not available, especially in the capital Islamabad. “Essential medicines like buprenorphine and morphine are also not available at most of the health facilities, which are used to treat extreme pain caused due to cancer”, one of the leading pain-management specialists in the capital, said.

Officials at the Drug Regulatory Authority of Pakistan (DRAP) said they were aware of the shortage of some of the essential medicines and a committee of the DRAP had recommended several steps to the authorities to ensure an uninterrupted supply of medicines to the people. “We are working day and night to ensure the provision of essential medicines to the people. The issue of LCs is being taken care of by the State Bank of Pakistan and Ministry of Finance while we are trying to make alternate arrangements for the import of ready-to-use medical products”, an official of the DRAP said.