If a medication is available in the US but not in your country, read When conventional access fails.
Specialty drug access in Pakistan: the named-patient pathway
From first request to drug delivery, a transparent walkthrough of every step.
Last reviewed 2026-05-01 by Reserve Meds clinical & regulatory team. Pakistan patients access specialty drugs through a specific regulatory framework documented here.
Why Pakistan patients face an access gap in the first place
Pakistan's specialty drug market has grown substantially with the expansion of private-sector tertiary hospitals, particularly Aga Khan University Hospital and Shaukat Khanum Memorial Cancer Hospital. The Drug Regulatory Authority of Pakistan (DRAP), under the Federal Ministry of National Health Services, regulates drug imports including the personal-use / named-patient pathway. The Pakistani healthcare market is structurally cash-pay-dominant for specialty medicines — private health insurance is a small share of the market and rarely covers named-patient imports.
Three patterns of access gap apply across Pakistan:
- Registered but not stocked. A drug is on the DRAP list but a particular hospital pharmacy does not have it on hand.
- Registered for a different indication. A drug is registered for one indication but the physician is prescribing it for another FDA-approved use that is not locally registered.
- Not registered locally at all. A drug is FDA-approved in the United States but the manufacturer has not pursued local registration, often because the patient population is small.
The DRAP (Drug Regulatory Authority of Pakistan) named-patient framework
Under DRAP's import provisions, a licensed Pakistani physician can request import of a small quantity of an unregistered medicine for personal use by a specific patient. The application is filed by the dispensing institution's import pharmacy. DRAP reviews clinical justification, the physician's PMDC (Pakistan Medical and Dental Council) license, product details, manufacturer authorization, and chain-of-custody. The framework is functional but slower than GCC peers, with routine cases typically requiring 25-40 business days.
The application includes:
- Clinical justification letter (diagnosis, severity, prior therapies, why this specific drug)
- Treating physician's local medical license verification
- Patient identifier (anonymized reference preferred)
- Product details: brand name, generic name, manufacturer, strength, quantity
- Destination dispensing facility license
- Chain-of-custody plan from US source to dispensing pharmacy
Approval timelines for routine cases are typically 25-40 business days. Complex cases (rare drug, novel mechanism, off-label use) can extend to 10-16 weeks.
Pakistan's private specialty hospital network
The hospitals that handle named-patient imports as established workflow include: Aga Khan University Hospital (Karachi), Shaukat Khanum Memorial Cancer Hospital (Lahore), Liaquat National Hospital (Karachi), Shifa International Hospital (Islamabad), Indus Hospital, Lady Reading Hospital (Peshawar). These institutions have import pharmacy infrastructure and physicians experienced with framework applications. If your treating physician is at a smaller institution without import infrastructure, we can help coordinate with one of these centers.
Real costs: what Pakistan patients actually pay
Costs vary widely by drug. For context, a 30-day supply of a major specialty oral oncology drug (for example, a kinase inhibitor or BTK inhibitor) typically falls in a USD 5,000-9,500 monthly range for the drug itself, plus international logistics (PKR-equivalent of USD 400-1,500 depending on cold chain), plus regulatory documentation handling fees, plus our concierge fee.
For a CAR-T or gene therapy with a list price of USD 400,000-2,000,000, the cost structure changes substantially: the drug dominates everything else. Reserve Meds' role shifts from cost optimization to logistical and regulatory orchestration.
The waitlist form generates an indicative range first, then a transparent firm quote with each line item separated. Nothing is bundled or hidden.
The patient experience: what your family actually does
From the family side, the process looks like this:
- Your physician decides this drug is the right next step. That is a clinical decision and stays with them.
- Your physician (or the hospital's pharmacy team) reaches out to Reserve Meds, or the patient submits the waitlist request and we connect with the physician.
- We confirm eligibility within 24-48 hours and send a documentation kit to your physician.
- Your physician fills out the named-patient application and submits it to DRAP.
- While the application processes, Reserve Meds aligns the US-side sourcing and shipment plan.
- Approval comes through. We ship cold-chain (or ambient, depending on the drug). Your hospital pharmacy receives the medicine.
- Your physician initiates therapy.
Common Pakistan-specific questions
How does the relative weakness of private health insurance affect Pakistan patients?
Pakistan's private health insurance market is small (estimated <5% of population) and rarely reimburses named-patient imports. Most patients are cash-pay funded by family resources, sometimes pooled across overseas family members in Saudi Arabia, UK, US, Canada, and Australia. Reserve Meds quotes in USD and accepts wire transfers from any USD-accessible source. We work with families coordinating funds across multiple countries. The pricing transparency on this site means patients can plan funding before contacting us.
What if the drug is a controlled substance?
Reserve Meds does not handle controlled substances (DEA Schedule I-V). Controlled-substance imports require separate regulatory coordination beyond the named-patient framework; we refer those cases to specialists.
Can I receive the drug at home or do I need a hospital?
The dispensing facility must be locally licensed. For oral medicines, a hospital outpatient pharmacy or specialized import pharmacy can dispense. For infusion products, the medicine ships to the infusion center where you will receive it. Direct-to-home delivery without a licensed dispensing facility in the chain is not the model.
What about pediatric patients?
The framework applies the same way for pediatric patients. The clinical justification letter typically includes weight-adjusted dosing and pediatric-specific monitoring requirements. The pediatric oncology and rare disease centers in Pakistan handle named-patient imports routinely.
Regional context
Pakistan's DRAP framework is the slowest among Reserve Meds' priority countries (25-40 business days routine vs. 5-15 for UAE). However, the private-sector tertiary network — Aga Khan, Shaukat Khanum, Liaquat National — handles named-patient imports as established workflow. Many Pakistani families with overseas members route through GCC tertiary centers (especially Dubai-area hospitals) for faster timelines, then bring the patient back to Pakistan for follow-on care.
Where Reserve Meds fits
Reserve Meds is a US-based concierge coordinator. We do not replace your physician, do not replace DRAP, do not replace your dispensing pharmacy. What we do is orchestrate the US-side sourcing, the regulatory documentation kit your physician needs, the international logistics, and a single named coordinator throughout your case.
For specialty oncology, rare disease, immunology, neurology, and other specialty therapies, this orchestration is the difference between an unpredictable ad-hoc process and a predictable, documented cycle.
This guide is informational, not medical or legal advice. The named-patient framework requires a licensed Pakistan physician's clinical judgment; Reserve Meds is the coordinator, not the prescriber.
Drug-access guides for Pakistan
Each guide below is a named-patient access pathway for that specific drug in Pakistan, with real timelines, costs, and the documentation your physician needs. These are coordinated by Reserve Meds for cross-border procurement.