State Bank of Pakistan Form FE-25 outward remittance for medical treatment, a 2026 walkthrough
By Reserve Meds · Clinical and regulatory team · Last reviewed 2026-05-17
What FE-25 is
Form FE-25 is the State Bank of Pakistan (SBP) prescribed application for outward remittance of foreign exchange for personal use, including medical treatment abroad and import of medicines for personal use. It is filed through an authorised dealer (a Pakistani commercial bank with an FX dealing licence) rather than directly with SBP.
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FE-25 is one route within SBP's Foreign Exchange Manual; medical-purpose remittance is covered in the Manual chapters governing private remittances and is subject to the prevailing FX policy circulars. The current circular series treats medical treatment abroad and personal-use medicine imports as eligible purposes within published ceilings.
Who can file
Any resident Pakistani individual holding a Pakistani CNIC and a bank account with an authorised dealer. The applicant typically remits on behalf of themselves or an immediate family dependant. For dependants, supporting documents (B-Form / CNIC of dependant, relationship affidavit) accompany the FE-25.
Documentation pack
1. Completed Form FE-25 (bank provides the current version; many authorised dealers also accept online submission via their internet banking).
2. CNIC copy of the remitter (and dependant where applicable).
3. Treating physician's letter on hospital letterhead, PMC-registered, stating diagnosis, treatment recommendation, and rationale for outward remittance.
4. Hospital or supplier invoice or quote (for Reserve Meds drug coordination, this is the Reserve Meds firm quote on Reserve Meds letterhead, plus the Pakistani receiving hospital's coordination letter where the drug is to be administered).
5. Beneficiary banking details (SWIFT/BIC, account, name, address).
6. Source-of-funds declaration where requested.
7. For amounts exceeding the standard ceiling, supplementary documentation supporting the medical justification.
Ceilings and supplementary approvals
SBP publishes per-individual annual ceilings for personal-purpose outward remittance, which are revised periodically. Medical-purpose remittance has historically attracted higher ceilings than general purposes. For amounts above the published ceiling, authorised dealers escalate to SBP for case-by-case approval; the medical-purpose pathway is structured to allow this approval where documentation supports it.
Patients with high-value specialty drug coordination (innovator biologics, gene therapy, oncology infusions) routinely use the supplementary-approval pathway. Reserve Meds quote letters are written to support this pathway: clear drug name, FDA-approval status, indication, dosing plan, and the role of the named Pakistani prescribing physician and receiving hospital pharmacy.
Authorised dealers
Major Pakistani commercial banks with active FX dealing capability include Habib Bank Limited (HBL), United Bank Limited (UBL), MCB Bank, Bank Alfalah, Standard Chartered Pakistan, Meezan Bank (Islamic), Allied Bank Limited (ABL), and Bank Al Habib. Each maintains an FX desk with experience in medical-purpose remittance. Patients typically use their existing primary banking relationship.
Timing
Standard FE-25 medical remittance, where the amount is within the published per-individual ceiling and documentation is complete, typically clears in 1-3 working days from submission. Supplementary-approval cases (above-ceiling) commonly take 2-3 weeks for SBP turnaround.
Reserve Meds recommends initiating the FE-25 process in parallel with the DRAP OIES Special Permission file; the two timelines can run concurrently rather than sequentially.
Frequently asked
Does Reserve Meds receive funds in PKR or USD? Reserve Meds banks in USD with US-based financial institutions; the outward remittance through FE-25 converts PKR to USD at the authorised dealer's prevailing rate.
Can the remittance be split across multiple FE-25 filings? Yes, where the total drug cost exceeds a single annual ceiling, multi-installment FE-25 filings are common (often aligned with refill cadence). The authorised dealer maintains the running total against the patient's annual ceiling.
What if the bank's FX desk is unfamiliar with named-patient drug import? Reserve Meds supplies a banking-letter template explaining the named-patient framework, DRAP authorisation status, and Reserve Meds's role. Most authorised dealers are comfortable with the structure once it is documented.
Is there sales tax or withholding on the outward remittance? Outward FX remittance for documented medical purposes is generally exempt from withholding tax; the authorised dealer applies the current FBR and SBP guidance.
Reserve Meds is a US-based concierge coordinator for cross-border specialty medicine. We are not a pharmacy, not the prescriber, and not the manufacturer. Cash-pay. Export-only (US to overseas). Composite case examples. Not medical advice.
Clinical and regulatory review: Mohammad Ali, MD (US-trained physician, Chief AI Officer, Reserve Meds). Last medically reviewed: 2026-05-17.
Regulatory framework and the SBP Form FE-25 outward medical remittance pathway in Pakistan, 2026
The Drug Regulatory Authority of Pakistan (DRAP) is the federal regulatory authority that governs medicine registration, manufacturing, and import in Pakistan. The official regulator portal is at www.dra.gov.pk; the locally registered medicines list is at www.dra.gov.pk/registered-drugs. The DRAP-administered One-Stop Industrial and Entrepreneur Services (OIES) portal handles the named-patient and personal-import application stream for reference-authority-approved medicines that are not yet held on the locally registered list at the time the case opens.
The qualifying conditions are stable across the recent regulatory cycle. The medicine must be approved by a recognised reference authority (US Food and Drug Administration or European Medicines Agency qualifies). No locally available alternative is clinically equivalent for the specific patient indication. The treating physician of record takes documented clinical responsibility. Chain of custody is preserved end to end from the source country (the US under Drug Supply Chain Security Act handling for Reserve Meds cases) through international transit to the named dispensing facility. The application is filed by the treating physician and the receiving institutional pharmacy through OIES; Reserve Meds provides the upstream sourcing, chain-of-custody documentation, and international shipping that the institutional pharmacy then attaches to its OIES file.
Tertiary centres and clinical coordination in Pakistan
The Pakistan tertiary referral network that most SBP Form FE-25 outward medical remittance cases route through includes Aga Khan University Hospital (AKUH) Karachi, Shaukat Khanum Memorial Cancer Hospital (SKMCH) Lahore and Peshawar, Indus Hospital and Health Network, Children's Hospital and Institute of Child Health Lahore, and Pakistan Institute of Medical Sciences (PIMS) Islamabad. These centres carry the haematology, oncology, neurology, metabolic, infectious-disease, and rare-disease specialist staffing and the institutional pharmacy and import-license operations that the named-patient pathway requires. For high-complexity therapies that need specialised infusion infrastructure, baseline organ-function workup, or post-treatment monitoring, the case is routinely referred to one of these centres from the outset.
For oral, subcutaneous, and standard in-clinic infusion therapies that can be administered in Pakistan 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. For therapies that require US-certified treatment center administration (some cell, gene, and complex biologics fall in this bucket), the practical access pathway shifts to patient travel; the Pakistan tertiary team continues to handle upstream referral package assembly and the long-term follow-up after the patient returns home.
Pakistan pricing reference and payer posture for SBP Form FE-25 outward medical remittance, 2026
Reserve Meds publishes a drug-only US cash-pay reference range at intake and issues a delivered, itemised quote within 24 hours once the treating physician's documentation is in. The 2026 reference rate used for PKR conversion is 1 USD = 280 PKR. Logistics, international shipment, chain-of-custody documentation, cold-chain handling where applicable, Reserve Meds concierge coordination, and any patient and caregiver travel and accommodation are itemised separately on every quote.
Payer posture in Pakistan for the SBP Form FE-25 outward medical remittance pathway is overwhelmingly cash-pay. The relevant federal scheme is Sehat Sahulat Program (provincial) and out-of-pocket spending dominates specialty cases; the portal is at sehat.gov.pk. Public coverage generally does not extend to non-locally-registered specialty named-patient cases. Private health insurance plans (Jubilee, EFU, Adamjee, TPL Life) 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. International outward remittance for the US drug invoice typically clears under the State Bank of Pakistan Form FE-25 framework for medical-treatment-related transfers; we provide the USD invoice the family then takes to their bank.
Access barriers in the SBP Form FE-25 outward medical remittance pathway and how Reserve Meds clears them
The five barriers that most often delay a SBP Form FE-25 outward medical remittance case in Pakistan are: (1) Regulatory documentation completeness. The DRAP OIES named-patient application package requires a specific bundle (physician clinical rationale letter, prescription with full strength and quantity, patient identifier, chain-of-custody plan, evidence of reference-authority approval, and confirmation that no locally available alternative is clinically equivalent). Reserve Meds provides physician-facing templates aligned to the format the reviewers expect. (2) US-side sourcing and DSCSA chain-of-custody. We coordinate with US-licensed specialty wholesale partners under the US Drug Supply Chain Security Act, logging every transfer point through to international shipment.
(3) Clinical eligibility documentation. The treating consultant at the prescribing tertiary centre defines eligibility against the FDA labelled indication and the relevant clinical-practice guideline; Reserve Meds does not adjudicate the clinical decision. (4) Family logistics. Patient and caregiver travel where applicable, accommodation near the treatment center where applicable, in-country transport, translator support where needed, and post-treatment data flow back to the treating Pakistan physician are coordinated as a single arc rather than as fragmented vendor handoffs. (5) Funding and remittance mechanics. Cash-pay is the default. For international transfers to the US source we provide an invoice in USD against the case quote; families coordinate the in-country remittance with their bank under the State Bank of Pakistan Form FE-25 framework for medical-treatment-related outbound transfers.
The Reserve Meds operating posture across the five barriers is the same in every Pakistan case: we resolve the operational, regulatory, sourcing, and logistics work; the treating physician of record holds the clinical authority; the family holds the funding and the final go/no-go.
Recent regulatory and access news for the SBP Form FE-25 outward medical remittance pathway in Pakistan, 2026
The Drug Regulatory Authority of Pakistan (DRAP) portal at www.dra.gov.pk and the locally registered medicines list at www.dra.gov.pk/registered-drugs are the authoritative source for the current Pakistan listing status of any specific medicine; the snapshot date governs. The FDA Drug Safety Communications feed at fda.gov drug-safety-communications and the FDA Drug Shortages list at accessdata.fda.gov drugshortages are the authoritative sources for any active safety advisory or supply-side shortage signal over the most recent 12-month window. The State Bank of Pakistan medical-remittance framework guidance at sbp.org.pk epd governs FE-25 outward remittance for treatment-related transfers. Reserve Meds refreshes this snapshot per case at intake; the snapshot date governs.