Medicines Consumption in Pakistan – Asrar Qureshi’s Blog Post #1017

Medicines Consumption in Pakistan – Asrar Qureshi’s Blog Post #1017

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1017 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to aq.pharmaveterans@gmail.com for publishing your contributions here.

Credit: Anna Tarazevich

Credit: Pavel Danilyuk

Credit: Tima Miroshnichenko

Preamble

Pharmaceutical industry is among major industries of Pakistan, and it is a significant and integral part of healthcare in the country. 

The volume of drug sales at the pharmacies is over one trillion rupees. The number of drugs runs into thousands. Being largely a generic market, multiple brands of the same drugs. There are over 700 manufacturing companies and a fairly big number of marketing companies. 

Generally, Pakistanis are not hypochondriac – means we are not overtly sensitive about our health. We usually don’t like to take medicines and keep finding excuses to stop treatment earlier than the doctor’s recommendation. Personally, I would say that our doctors overtreat patients, but this is my view, and others do not need to agree with it.

IQVIA – is an American company that collects and publishes pharmaceutical industry data in many countries of the world, Pakistan also. They have a full office and set up here. Every quarter they publish data which is copyright for them and their subscribers. 

I shall give my readers a snapshot of where the industry is today. I shall discuss trends rather than figures because figures do not concern us in this space.

Lastly, Pakistan pharma market is very unevenly divided. Over 90% share is monopolized by about top 50 companies. This means that only about 6% companies have captured over 90% space. This is clear monopolization, and it is stifling and unfair to competitors.

Pharmaceutical Market Performance During FY 2023-2024

Pakistan follows July-June year for all financial working; budgets are made, taxes are collected, and all things financial are considered in 12-month span starting at July and ending in June. We see pharmaceutical market and industry performance during this period, from July 2023 to June 2024.

Market Dynamics

The market grew by more than 20% over last financial year. It will be more understandable if we say that the revenue earned by pharma companies was almost 170 billion rupees more than last year. It is a very impressive performance by any standard. We also understand that some data cannot be captured due to our undocumented economy and that probably over 200 billion rupees would have been added. Although pharma industry is highly regulated but all the same.

The above revenue does not include billions of rupees worth of medicines purchased by the government/ public healthcare system to run their large and small hospitals, dispensaries etc. 

Medicine business is primarily population dependent, and then on environment, health status, disease prevalence, access to medical care, economy, patient purchasing power, and continuous availability of medicines in every corner of the country. 

Our population is growing at an uncontrollable rate. The last digital census confirmed 2.5% growth overall; Balochistan was an exception at 3.2%. Our population growth must be among the highest in the world, if not the highest. More people need more medicines, hence business growth.

Environment is quite toxic in most parts of the country even without smog; smog only adds to pollution when all suspended particles come down and get inside us. Our people are destroying environment through large industries, cottage industry, pesticides, filth, trash, unleashed housing schemes, deforestation, and everything else which harms environment. This is leading to increase in various diseases.

Pakistan is already known to have prevalence certain diseases endemically. Hepatitis B & C, Typhoid, Malaria, Dengue, etc. prevail among a large population. As always, we do not collect data, but such patients run into millions. These patients must take medicines for various lengths of time. Pakistan also has a very high incidence of diabetes which is currently estimated at 33%, or that every third person is a diabetic. Diabetes is a lifelong disease and needs lifelong medication.

Most major industries do not have wastewater treatment plants; small ones do not even think. There is an Environment Protection Agency – EPA – whose job is to ensure that industries follow the environmental regulations, and they do pay periodic visits to industries, but only to collect bribe money. The EPA is among the least performing agencies. 

Use of pesticides is promoted and glorified through affluent farmers who are wealthy due to pesticides, they have attractive wives, smart children, posh houses, and brand-new cars. All of it is a scam because farmers with small to medium landholdings are struggling to make both ends meet. They are coerced into using pesticides through various means.

Access to medical care has certainly improved and keeps improving every year. 114 public and private medical colleges are churning out thousands of doctors every year. The attrition among female doctors is quite high as many of them choose not to work or may not be allowed to work. All new doctors cannot settle in big cities and choose to go to their native towns or even farther. Whatever the quality, but the access is certainly increasing.

Availability of medicines in Pakistan is excellent. You can find medicines even in the remotest parts, thanks to a large network of distributors, wholesalers, suppliers, and retailers. Shortage of various essential drugs had been plaguing for long due to very low prices leading to non-production. Recent changes deregulating price control on a large number of products has improved the availability further.

Patient Purchasing Power has gone down due to economy downturn. Businesses have ceased to exist, have downsized, stopped hiring, shelved expansion plans, rightsized team and clubbed resources together. Pakistan still has very low medicine prices, but due to recent increases, these are getting out of the reach of majority.

Interesting Nuggets

• Panadol (brand of paracetamol) is the biggest product by volume, followed by Augmentin, Risek, Brufen, Methycobal, Flagyl, and Novidat, all multibillion-rupee products.

• Over 40 medicines sell more than one crore packs in a year: highest one at 9 crore packs.

• Pakistani companies now occupy two top positions in market revenue.

• Between April and June 2024, prices for over 1,100 medicines were increased.

• 599 new products were launched in one year; the most active company launched almost three products every month. 

Sum Up

Pharmaceutical industry in Pakistan is a vibrant and thriving industry which is growing at a fast pace despite its unevenness. While the industry must be credited with making Pakistan self-sufficient with local production and with making medicines available everywhere, the recent price increases and business tactics need review.

Concluded.

Disclaimers: Pictures in these blogs are taken from free resources at Pexels, Pixabay, Unsplash, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, however, it happens unintentionally, I offer my sincere regrets.