Pakistan's HCV elimination program and how Reserve Meds fits the named-patient gap
By Reserve Meds · Clinical and regulatory team · Last reviewed 2026-05-17
Why Pakistan's HCV burden matters
Pakistan carries one of the highest hepatitis C virus prevalence rates globally, with WHO and federal Ministry of National Health Services estimates placing chronic HCV prevalence between 5 and 8 percent in adults. Punjab districts such as Sialkot, Gujranwala, and parts of southern Punjab show the highest district-level prevalence.
The Prime Minister's National Programme for Prevention and Control of Hepatitis, re-launched in 2023 with provincial counterparts in Punjab, Sindh, KP, and Balochistan, anchors public-sector direct-acting antiviral (DAA) distribution. The headline pangenotypic regimen is generic sofosbuvir 400 mg plus velpatasvir 100 mg for 12 weeks.
Where the public-sector program covers patients
If a patient screens positive on rapid antibody test, then confirms HCV RNA PCR, and meets program enrolment criteria, the provincial program supplies generic DAAs free of charge through designated public-sector hepatology centres. This is the right first stop for most Pakistani HCV patients.
Pakistan Kidney and Liver Institute and Research Center (PKLI&RC) in Lahore, Aga Khan University Hospital (Karachi), Shaukat Khanum Memorial (Lahore), Liaquat National Hospital (Karachi), Indus Hospital, and Shifa International (Islamabad) all coordinate with the federal programme for confirmatory testing, fibrosis staging via Fibroscan, and DAA initiation.
Where named-patient innovator imports come in
Some clinical situations are not well served by generic DAA pickup. Decompensated cirrhosis (Child-Pugh B/C), HIV/HCV coinfection requiring innovator-grade purity for drug-interaction certainty, prior DAA failure requiring sofosbuvir/velpatasvir/voxilaprevir (Vosevi) salvage, and post-transplant retreatment all benefit from innovator product where chain-of-custody is documented end-to-end.
DRAP's Personal Use Import / Named Patient framework, filed through the One-Stop Industrial and Entrepreneur Services (OIES) portal at dra.gov.pk, permits a treating hepatologist to import Epclusa, Vosevi, or Harvoni from a DSCSA-compliant US wholesale chain when (a) the medicine is FDA-approved, (b) no locally registered equivalent fits the clinical need, and (c) the physician accepts clinical responsibility.
How Reserve Meds fits
Reserve Meds sources Epclusa, Vosevi, and Harvoni from US-licensed specialty wholesale partners under DSCSA chain-of-custody, files the DRAP OIES Special Permission application alongside your hepatologist, handles importer-of-record customs clearance, and delivers to the nominated PKLI / AKU / Shifa pharmacy.
We do not displace the federal programme. For routine genotype 1-6 patients without complicating factors, the public-sector generic pathway is faster, free, and clinically appropriate. Reserve Meds handles the edge cases.
Indicative timing and cost (cash-pay)
Indicative timing for a complete OIES Special Permission file from a credentialed hepatologist: 15-30 working days, with expedited processing in 7-10 days for decompensated or post-transplant cases.
Indicative annual cash-pay cost for innovator Epclusa (12-week regimen): USD 24,000-28,000 drug-only at US WAC, with Reserve Meds concierge, DRAP filing, cold-chain shipping, and PKLI/AKU/Shifa delivery layered on top. In PKR at a working exchange rate of approximately 280 PKR/USD, that is roughly 67-79 lakh rupees per 12-week course. Reserve Meds issues a firm quote at intake.
Documentation your hepatologist needs
HCV antibody-positive plus HCV RNA-positive confirmation, genotype where available, fibrosis staging (Fibroscan or APRI/FIB-4), prior DAA exposure history if any, Child-Pugh stage if cirrhotic, HIV co-infection status, PMC registration number, and OIES Special Permission application form. Reserve Meds supplies the documentation template and regulatory liaison.
Frequently asked
Is generic sofosbuvir/velpatasvir as good as innovator Epclusa? For genotype 1-6 treatment-naive non-cirrhotic patients, current evidence supports equivalent SVR12. For decompensated, post-transplant, or DAA-experienced patients, innovator-grade supply is preferred by many hepatologists for chain-of-custody certainty.
Will the federal programme accept a private-sector import alongside their generic protocol? Yes, where clinically justified. The OIES file references the patient's existing programme registration and explains the clinical rationale.
Can pediatric HCV patients be enrolled? The federal programme primarily targets adults; pediatric HCV is treated under hepatology specialist supervision at AKU, PKLI, and Shaukat Khanum. Pediatric DAA dosing (sofosbuvir/velpatasvir granules) is more often a named-patient innovator import.
What is the SVR12 success rate for the elimination programme? Federal programme reporting in 2024-2025 cycles shows SVR12 rates of approximately 92-95 percent across treated cohorts, consistent with international generic DAA outcomes.
Reserve Meds is a US-based concierge coordinator for cross-border specialty medicine. We are in pre-launch; service availability is limited to our first cohort and published timelines are indicative, not guarantees. Cash-pay. Export-only (US to overseas). Composite case examples. Not medical advice.
Clinical and regulatory review: Reserve Meds clinical team and AI regulatory-counsel review pipeline. Last medically reviewed: 2026-05-17.