How to access Krazati from Oman, the named-patient import pathway, 2026
*Clinically reviewed by Mohammad Ali, MD (US-trained physician, Chief AI Officer, Reserve Meds). Last reviewed 2026-05-13.
An Omani patient with locally advanced or metastatic non-small cell lung cancer (NSCLC) carrying a KRAS G12C mutation, after at least one prior systemic therapy, or with KRAS G12C-mutated locally advanced or metastatic colorectal cancer (in combination with cetuximab), may receive a prescription for Krazati (adagrasib) from their treating oncologist. Krazati is FDA-approved in the United States and now manufactured by Bristol Myers Squibb following the BMS acquisition of Mirati Therapeutics. It is a small-molecule KRAS G12C covalent inhibitor administered orally. Local availability of Krazati in the Kingdom of Oman can be inconsistent: the drug may not be on every oncology pharmacy's standing formulary, the specific indication may not match what is locally registered, or the strength required may be back-ordered. When that happens, a named-patient import pathway through the Directorate General of Pharmaceutical Affairs and Drug Control (DGPADC) remains a legitimate route for the patient whose physician has already prescribed the drug.
This guide explains the pathway, the documentation your physician needs, typical costs and indicative timing, and where Reserve Meds fits in.
The clinical situation
Krazati covalently binds the cysteine at position 12 of the mutant KRAS G12C protein, locking it in the inactive GDP-bound state. Standard adult dosing is 600 mg orally twice daily. Confirmation of a KRAS G12C mutation by an FDA-approved companion diagnostic, or an equivalent locally accredited next-generation sequencing test, is required before initiation. Baseline workup per FDA labeling includes complete blood count, hepatic function, renal function, electrolytes (magnesium, potassium), ECG (QTc prolongation is a known signal, especially with concomitant QT-prolonging agents or CYP3A inhibitors), and pregnancy testing where applicable. Important warnings include gastrointestinal adverse reactions, QTc interval prolongation, hepatotoxicity, interstitial lung disease and pneumonitis, and embryo-fetal toxicity. Your oncologist will discuss the risk-benefit profile and schedule monitoring before initiating therapy.
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Is Krazati legally importable into Oman?
Yes, through the Directorate General of Pharmaceutical Affairs and Drug Control (DGPADC) named-patient and personal-use import framework, coordinated with the treating facility's pharmacy. The Kingdom has an established pathway for specialty oncology medicines approved by reference authorities (US FDA, EMA, MHRA) but not stocked or registered for the specific indication locally.
The DGPADC named-patient route allows an Oman-licensed physician to request import of a medicine when: (a) the medicine is approved by a recognised reference authority, (b) no clinically equivalent locally registered alternative is suitable for the patient's indication and history, (c) the treating physician takes clinical responsibility for use, and (d) chain of custody is documented from the US source to the administering facility.
How the pathway works, step by step
- Consultation with your treating oncologist. The prescribing decision is clinical. Your oncologist documents the indication, KRAS G12C mutation status (NGS or companion diagnostic report), prior therapies, and rationale for Krazati.
- Baseline screening. CBC, LFTs, renal function, electrolytes, ECG, and pregnancy testing where applicable are confirmed and documented. Concomitant medication review for CYP3A and QT-prolonging interactions is performed.
- DGPADC named-patient application. Your oncologist or the hospital's import pharmacy files the application with clinical rationale, mutation status documentation, patient reference, product strength (200 mg tablets), quantity requested, and chain-of-custody plan.
- US-side sourcing. Reserve Meds coordinates with our US-licensed specialty wholesale partner to secure product from Bristol Myers Squibb's authorised distribution under DSCSA chain-of-custody.
- Shipment. Krazati is an oral tablet with controlled-room-temperature storage requirements. Shipments include temperature-monitored packaging and tamper-evident seals.
- Arrival and first dose. The dispensing pharmacy releases product against the physician's prescription, and your oncologist initiates therapy with scheduled ECG and lab follow-up.
What documentation your physician needs
Your physician will typically need to provide:
- A clinical rationale letter confirming diagnosis, KRAS G12C mutation status (with NGS or companion diagnostic report), prior therapy history, and Krazati as the indicated next step
- Verification of their Oman medical licence (SCFHS registration)
- A patient identifier, anonymised reference where privacy is preferred
- Documented pre-treatment screening (CBC, LFTs, renal, electrolytes, ECG) consistent with FDA labeling
- The planned dosing strength and schedule (600 mg twice daily; with cetuximab if colorectal indication)
- A discussion note on the QTc monitoring plan and concomitant medication review
Reserve Meds provides a physician documentation kit that bundles the templates DGPADC reviewers expect to see for KRAS G12C targeted therapy.
Typical costs and indicative timing
Reserve Meds gives you a drug-only reference range plus a transparent delivered quote at intake. As an illustrative composite case, the US cash-pay reference range for a 30-day supply of Krazati (600 mg BID) sits in an indicative 2026 band of roughly USD 21,000 to 25,000. International logistics, DGPADC documentation handling, shipping, and concierge coordination add incremental cost. The delivered quote we issue at intake shows each line separately.
Indicative timing for first dose after cohort intake opens is approximately 2 to 5 weeks from the moment a complete application is submitted to DGPADC, assuming the documentation package and KRAS G12C report are clean on first pass. Refills ship on a rolling cadence aligned to your monthly supply.
Where Reserve Meds fits in
Reserve Meds is a US-based concierge coordinator for cross-border specialty medicine. For Krazati specifically, we provide:
- Sourcing. Through our US-licensed specialty wholesale partner, operating under DSCSA chain-of-custody from manufacturer to export.
- Documentation. Regulatory package tailored for your physician and for DGPADC review, including QTc and CYP3A interaction monitoring templates.
- Logistics. Temperature-monitored, internationally tracked shipment to your named dispensing facility.
- Concierge case lead. A named point of contact for your family and your physician across the full case arc.
We are a coordinator. We are not the prescriber, not a pharmacy, and not a dispensing facility. All clinical decisions remain with your treating oncologist, and dispensing sits with the licensed Oman pharmacy of record. Reserve Meds operates on cash-pay only and does not bill insurance.
Frequently asked
Is this legal in Oman? Yes, when executed through the DGPADC named-patient and personal-use framework with appropriate documentation, clinical rationale, and a licensed dispensing facility. The pathway is routinely used across Oman oncology.
How does Krazati compare with Lumakras (sotorasib)? Both are KRAS G12C inhibitors. Krazati has CNS penetration data and a separate FDA-approved indication in colorectal cancer with cetuximab. Lumakras (sotorasib) is the alternative G12C inhibitor with a once-daily schedule. Your oncologist makes that determination based on your tumor type, brain metastasis status, and prior therapy.
What about the QTc warning? Krazati can prolong the QTc interval and interacts with CYP3A and other QT-prolonging drugs. Your oncologist will review concomitant medications and schedule ECG monitoring per labeling. Reserve Meds does not make that clinical judgement, your physician does.
Will my private health insurance cover this? Cash-pay is the default posture. Some Oman private insurers and CCHI-aligned plans reimburse named-patient oncology imports on a case-by-case basis when the documentation package is strong. We supply documentation for your submission but do not process insurance claims.
What if my oncologist has not filed a named-patient request before? Named-patient import is an institutional process most major Oman cancer centers (The Royal Hospital Muscat, Sultan Qaboos University Hospital (SQUH), Khoula Hospital, Armed Forces Hospital, and Muscat Private Hospital) have encountered. Our documentation kit is written for first-time applicants and tracks what DGPADC reviewers commonly ask for.
Next step
For Krazati coordination in the Kingdom of Oman, start your case at the portal or message us on WhatsApp. Our concierge case lead will respond within 24 hours.
Composite case examples. This content is for general information and does not constitute medical advice.
Regulatory status of Krazati in Oman, 2026
Krazati (adagrasib) is not currently held on the locally registered medicines list of the Oman Ministry of Health Directorate General of Pharmaceutical Affairs and Drug Control (MOH-Oman). The product is approved by the US Food and Drug Administration per the labelled indication of KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer after at least one prior systemic therapy, and KRAS G12C-mutated locally advanced or metastatic colorectal cancer in combination with cetuximab (see the FDA label at accessdata.fda.gov). The European Medicines Agency holds a parallel marketing authorisation where applicable (see the EMA EPAR at ema.europa.eu).
Because Krazati is not on the MOH-Oman locally registered list, access for a Oman-based patient runs through the named-patient and personal-import framework that the MOH-Oman maintains for reference-authority-approved medicines that are not held locally. The official MOH-Oman portal is at www.moh.gov.om. The qualifying conditions are well established: the medicine is approved by a recognised reference authority (FDA or EMA qualifies); no locally available alternative is clinically equivalent for the specific patient indication; the treating physician of record takes documented clinical responsibility; and chain of custody is preserved end to end from the US source through international transit to the named dispensing facility.
The named-patient and personal-import pathway is the routine framework. For a complex cell or gene therapy that requires a US-certified treatment center, the practical route is patient travel to that certified center rather than import into Oman; see Block 2 below for the operational shape on that case type.
Tertiary centers and clinical coordination in Oman
The Oman tertiary referral network for a Krazati case is concentrated at Sultan Qaboos University Hospital (SQUH), Royal Hospital, and Sultan Qaboos Comprehensive Cancer Care and Research Centre. These centers carry the haematology, oncology, paediatric subspecialty, or rare-disease specialist staffing and the institutional pharmacy and import-license operations that the named-patient pathway requires. For cellular and gene therapies that require leukapheresis collection, AAV infusion, or post-treatment monitoring of a complexity beyond what a community centre is configured for, the case is routinely referred to one of these tertiary centers from the outset.
For cell and gene therapies specifically, the practical access pathway runs through patient travel to a US-certified treatment center (Casgevy authorised treatment centers, Yescarta certified centers, Abecma certified centers, Zolgensma certified centers, Elevidys treatment centers, Hemgenix treatment centers, and so on) rather than import of the cellular or AAV product into Oman. The tertiary Oman centers handle the upstream referral package assembly (clinical summary, pathology, imaging, organ function panel, infectious disease screen, performance status), the US-side coordination, and the long-term follow-up after the patient returns home. Reserve Meds coordinates the cross-border arc between the Oman tertiary team and the US treatment center, including travel and accommodation logistics, financial clearance, and post-treatment data flow.
For oral kinase inhibitors and antibody therapies that can be administered in Oman once imported, the tertiary centres dispense and monitor under their institutional pharmacy operations. Reserve Meds handles US-side sourcing under Drug Supply Chain Security Act (DSCSA) chain-of-custody documentation, international shipment to the named dispensing facility, and re-supply cadence aligned to the dosing schedule.
Oman pricing reference and payer posture, 2026
Reserve Meds publishes a drug-only US cash-pay reference range at intake and issues a delivered, itemised quote within 24 hours once your treating physician's documentation is in. As an illustrative composite case in the 2026 reference band, the US cash-pay drug-only range for Krazati sits at approximately USD 22,000 to USD 25,000 per 30-day supply at the labelled 600 mg twice-daily oral dose (US wholesale acquisition cost). In OMR terms at the 2026 reference rate of 1 USD = 0.385 OMR, that translates to a drug-only band of approximately OMR 8,470 to OMR 9,625.
Logistics, international shipment, chain-of-custody documentation, cold-chain handling where applicable, US treatment center facility and physician fees where applicable (for cellular and gene therapies, the facility cost commonly equals or exceeds the product cost), Reserve Meds concierge coordination, and any patient and caregiver travel and accommodation are itemised separately. For a cell or gene therapy case the total course cost in 2026 commonly lands at 1.5x to 2.5x the drug-only band once US treatment center fees, lymphodepletion or pre-infusion conditioning, inpatient monitoring, complication management, and family travel and accommodation are added in.
Payer posture in Oman is overwhelmingly cash-pay for named-patient imports and cross-border CAR-T cases. Public coverage (Dhamani national mandatory insurance phased rollout) generally does not extend to non-locally-registered specialty cases. Private health insurance plans review case-by-case on a pre-authorisation basis when the documentation package is strong, but cash-pay should be assumed as the default at intake.
Access barriers and how Reserve Meds clears them
The five access barriers we see most often for a Krazati case in Oman are: (1) Regulatory documentation complexity. The MOH-Oman named-patient and personal-import application package requires a specific bundle (physician clinical rationale letter, prescription, patient identifier, product strength and quantity, chain-of-custody plan, evidence of reference-authority approval, and confirmation that no locally available alternative is clinically equivalent for the patient). Reserve Meds provides physician-facing templates that match the format MOH-Oman reviewers expect. (2) US-side sourcing and DSCSA chain-of-custody. We coordinate with our US-licensed specialty wholesale partners to secure Krazati from authorised distribution under the US Drug Supply Chain Security Act, logging every transfer point through to international shipment.
(3) For cell and gene therapies, the US-certified treatment center qualification gate. Casgevy, Yescarta, Carvykti, Abecma, Zolgensma, Elevidys, Hemgenix, and Luxturna can only be administered at a manufacturer-certified treatment center. Reserve Meds maintains the referral arcs to the appropriate US-certified centers and handles the referral package routing, financial clearance, and the multi-week stay coordination. (4) Family logistics. Patient and caregiver travel, accommodation near the treatment center, in-US transport, translator support where needed, and post-treatment data flow back to the treating Oman physician are coordinated as a single arc. (5) Insurance and payer posture. Cash-pay is the default. Where private insurance review is contemplated, we supply documentation for the family's submission but we do not bill insurers and we do not adjudicate insurance disputes.
Drug-specific clinical context for Krazati: the labelled indication is KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer after at least one prior systemic therapy, and KRAS G12C-mutated locally advanced or metastatic colorectal cancer in combination with cetuximab. The relevant clinical-practice guideline body is NCCN non-small cell lung cancer guidelines at www.nccn.org. Your treating physician of record makes the clinical decision; Reserve Meds is the coordination layer that clears the operational and regulatory barriers between the prescription and the delivered course.
Recent regulatory and access news for Krazati in Oman, 2026
The Oman Ministry of Health Directorate General of Pharmaceutical Affairs and Drug Control (MOH-Oman) portal at www.moh.gov.om has not posted a Krazati-specific listing on the publicly searchable locally registered medicines list at www.moh.gov.om/en/pharmaceutical-affairs as of 2026-06-04. The FDA Drug Safety Communications feed at fda.gov drug-safety-communications and the FDA Drug Shortages list at accessdata.fda.gov drugshortages have not registered a Krazati-specific safety advisory or shortage signal over the most recent 12-month window. The FDA labelled indication remains KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer after at least one prior systemic therapy, and KRAS G12C-mutated locally advanced or metastatic colorectal cancer in combination with cetuximab (see the current label at accessdata.fda.gov). Bristol Myers Squibb (acquired Mirati Therapeutics) continues commercial supply per the FDA-labelled indication and the EMA marketing authorisation. The NCCN non-small cell lung cancer guidelines guidance at www.nccn.org remains the relevant clinical-practice reference. Reserve Meds refreshes this snapshot per case at intake; the snapshot date governs.