Cosentyx access in Pakistan: the DRAP named-patient pathway
How patients in the Islamic Republic of Pakistan legally obtain Cosentyx (secukinumab) when the locally registered indication, stocked presentation, or payer coverage does not match what the prescribing physician has written.
Last reviewed 2026-05-12 by Reserve Meds clinical and regulatory team.
Quick orientation
Patients in Pakistan access Cosentyx (secukinumab) for moderate-to-severe plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, enthesitis-related arthritis, juvenile psoriatic arthritis, and hidradenitis suppurativa in adults through the DRAP named-patient pathway, a Drug Regulatory Authority of Pakistan-administered mechanism that allows a Pakistani-licensed physician at a registered facility to import the FDA-labelled product for a specific named patient. This page details the documentation, approval timeline, and real cost in PKR.
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How Cosentyx reaches patients in Pakistan
Cosentyx (secukinumab, a fully human IgG1 monoclonal antibody targeting interleukin-17A from Novartis, FDA-approved 21 January 2015 with sequential label expansions across plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, hidradenitis suppurativa, paediatric plaque psoriasis, enthesitis-related arthritis, juvenile psoriatic arthritis, and most recently giant cell arteritis) may appear on the DRAP registered-product verification portal at dra.gov.pk/e-services/online-data-verification for selected indications via the local Novartis Pakistan affiliate, but stocked presentations, the specific FDA-labelled paediatric or rare-indication strengths, and the prefilled-pen presentation are not consistently available as of 2026-06-01. Patients access non-stocked Cosentyx presentations under the Special Permission for Import of Therapeutic Goods for Personal Use (the patient-named No Objection Certificate or NOC), administered by the Import and Export Section of the DRAP Quality Assurance and Laboratory Testing Division under the Drugs Act 1976 read with the Drugs (Import and Export) Rules 1976 and DRAP Guidance Document QALT/GL/IP/004 at dra.gov.pk Guidance. The application is filed online via the DRAP Special Permissions portal at dra.gov.pk Special Permissions. DRAP does not publish a fixed processing-time SLA; patient-org reporting indicates several working days when documentation is complete. For Cosentyx specifically, the clinical justification must reference the confirmed FDA-labelled indication (with documented disease-activity scores such as PASI for psoriasis, BASDAI for axial spondyloarthritis, ACR for psoriatic arthritis, HiSCR for hidradenitis suppurativa), prior conventional or biologic therapy exposure and failure where applicable, the planned induction and maintenance dosing schedule per the FDA Cosentyx label for the specific indication, the latent tuberculosis screen result and infection-monitoring plan, and the prescriber's specialty (dermatology, rheumatology, gastroenterology, or paediatric subspecialty). The prescribing physician must be registered with the Pakistan Medical and Dental Council.
Where Cosentyx is dispensed in Pakistan
Cosentyx is a subcutaneous monoclonal antibody supplied as a prefilled syringe, prefilled pen, or lyophilised vial across labelled adult and paediatric dosing strengths. The dispensing site must maintain 2 to 8 degrees Celsius refrigerated storage with continuous temperature logging, run baseline tuberculosis screening (interferon-gamma release assay or tuberculin skin test plus chest imaging), assess hepatitis B and C and inflammatory bowel disease history, and train the patient or caregiver on self-administration. Pakistani institutions with adult or paediatric dermatology and rheumatology capability appropriate to IL-17A inhibitor therapy include the Department of Dermatology and Department of Rheumatology at Aga Khan University Hospital (AKUH) in Karachi at hospitals.aku.edu; the Department of Dermatology and Department of Medicine, Rheumatology Section at Shifa International Hospital in Islamabad; the Department of Dermatology at Jinnah Postgraduate Medical Centre (JPMC) in Karachi; the Mayo Hospital Department of Dermatology under King Edward Medical University in Lahore; and the Department of Dermatology at Liaquat National Hospital in Karachi. For paediatric plaque psoriasis, enthesitis-related arthritis, and juvenile psoriatic arthritis cases, The Children's Hospital and Institute of Child Health in Lahore is the primary paediatric tertiary centre. AKUH and Shifa publish departmental leadership and are the most-frequent nodes for biologic immunology specialty imports requiring cold-chain handling and self-administration training.
What Cosentyx costs in Pakistan
The US wholesale acquisition cost for Cosentyx is approximately USD 6,720 per 300 mg dose (two 150 mg prefilled-pen units) and approximately USD 80,000 to USD 90,000 per patient per year at the standard adult plaque psoriasis maintenance regimen of 300 mg every four weeks after a five-week loading phase per Novartis disclosures and Drugs@FDA at accessdata.fda.gov/scripts/cder/daf. Annual cost varies by indication; hidradenitis suppurativa at 300 mg every two weeks during maintenance runs roughly twice the psoriasis annual cost. A locally registered Cosentyx presentation has historically been available through Novartis Pakistan at a discounted price relative to US WAC; the DRAP Maximum Retail Price for the locally registered presentation should be confirmed at the dispensing pharmacy at quote time rather than estimated. No public PKR benchmark for the FDA-labelled paediatric or rare-indication presentations on the DRAP MRP database has been observed as of 2026-06-01; do not estimate. Price snapshot: 2026-06-01. Cost layers above the drug cost include validated cold-chain international logistics into Pakistan (2 to 8 degrees Celsius with continuous monitoring), DRAP NOC and Federal Board of Revenue customs fees (nominal relative to drug cost), the dispensing hospital's outpatient pharmacy and patient-training fees, and the Reserve Meds concierge fee itemised separately on every firm quote. Novartis US patient services do not extend to Pakistani residents.
Funding and access barriers for Cosentyx in Pakistan
Public-sector funding of named-patient biologic imports for chronic dermatology and rheumatology indications in Pakistan is largely case-by-case. The Sehat Sahulat Programme at pmhealthprogramme.gov.pk covers inpatient hospitalisation and selected chronic-disease therapies for enrolled families; the per-family annual ceiling does not generally stretch to a US biologic price point of USD 80,000 plus per year and the programme is built around in-network empaneled hospital treatment rather than imported drug procurement. Khyber Pakhtunkhwa's Sehat Card Plus has the broadest provincial specialty cover. Pakistan Bait-ul-Mal at pbm.gov.pk offers case-by-case grants for high-cost treatment. Major private insurers including Jubilee Life Insurance, EFU Life, State Life Insurance Corporation, and Adamjee Life do not publish biologic-coverage formularies, and IL-17A inhibitor coverage for chronic indications is assessed case-by-case, typically requiring documented failure of methotrexate, cyclosporine, NSAIDs, sulfasalazine, or another conventional disease-modifying agent for step-therapy adjudication. Pakistan's out-of-pocket share of health expenditure consistently sits above 50 percent per World Bank data at data.worldbank.org; for chronic immunology biologics the dominant funding pattern is self-pay supplemented by family fundraising and overseas-relative remittances. Where the locally registered Novartis Pakistan Cosentyx presentation is in stock, families and prescribers typically use that route first; the FDA-labelled paediatric or rare-indication NOC pathway is reserved for cases where local stock does not match the prescribed presentation or where local pricing exceeds the international NOC cost layer.
Recent regulatory and access news for Cosentyx
DRAP published the consolidated Guidance Document for Applicants on Import and Export Permissions of Therapeutic Goods (QALT/GL/IP/004) covering personal-use, institutional, and donation imports, the current operative reference for any Cosentyx NOC application; full notice at dra.gov.pk regulatory updates. The Federal Cabinet of Pakistan approved an exemption for the import of unregistered drugs in defined public-interest cases under Section 23 of the Drugs Act 1976, broadening the institutional-import lane for high-cost rare drugs not commercially available in Pakistan, reported at Express Tribune. On the manufacturer side, the FDA approved Cosentyx for giant cell arteritis in adults on 31 March 2025, the most recent label expansion adding a new specialty indication that lacks Pakistani local stocking. No drug-specific DRAP bulletin for Cosentyx over the last 12 months has been observed as of 2026-06-01.
Where Reserve Meds fits in Cosentyx cases
Reserve Meds is a US-based concierge coordinator. We do not replace your treating physician, we do not replace DRAP, and we do not replace your dispensing pharmacy. For Cosentyx specifically, we orchestrate the US-side sourcing through a DSCSA-compliant specialty channel, build the documentation packet your physician submits, coordinate validated logistics (cold-chain with continuous temperature logging where the FDA label requires it) into Pakistan, and assign a single named coordinator through the case. Standard named-patient coordination under our specialty playbook applies. Presentation selection, dose-band confirmation, and patient onboarding for self-administration where applicable are the recurring operational fundamentals we expect for this drug.
Operationally, a typical Cosentyx case runs across four parallel tracks. The clinical track is the physician's: justification letter, dosing plan, monitoring schedule, and the next patient-facing follow-up. The regulatory track is the DRAP application packaged by the importer; we provide the documentation template, the dispensing facility license check, and the chain-of-custody attestation. The logistics track is the US-side sourcing and the validated international shipment with continuous temperature logging and customs broker coordination. The patient-experience track is the named coordinator who keeps everyone aligned on dates, addresses dispensing-pharmacy questions, and confirms the medicine has been received and stored correctly. The four tracks are run in parallel rather than in series; that is the operational difference between a 3-week and a 9-week case.
Cosentyx is a cold-chain biologic requiring 2 to 8 degrees Celsius storage from the US manufacturer through the Pakistan dispensing pharmacy with continuous temperature logging. Before initiating, the FDA label requires tuberculosis screening and hepatitis B serology; named-patient files document the QuantiFERON or tuberculin status, HBsAg/anti-HBc results, and any latent TB prophylaxis plan. Pen-injector or pre-filled syringe training and the planned dermatology, rheumatology, or gastroenterology follow-up complete the package.
Next step
If your Pakistani physician has prescribed Cosentyx and you are weighing the cross-border route, the next step is a short intake. We confirm eligibility within 24 to 48 hours and send a documentation kit to your physician.
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