Abstract：
OBJECTIVE: The lack of anticancer drugs for curative and supportive purposes is the critical reason for the low survival rate in low-and-middle-income countries. This study aims to analyze whether the National Essential Medicines List (NEML) and Registered Essential Medicines List (REML) are in concordance with the World Health Organization (WHO) Essential Medicines List (EML) and whether the formularies prevalent in the country are parallel to each other and to the NEML.
METHODS: An observational study design was used in which antineoplastic drugs from the 2021 NEML and REML were compared with 2021 WHO EML to evaluate their availability in Pakistan. Market access was determined. Moreover, the formularies of six different hospital types were compared with each other and with the NEML, and REML to estimate the availability within hospitals.
RESULTS: There were 66 anticancer drugs in 2021 WHO EML and all were found in Pakistan\'s 2021 NEML but only 48 drugs (73%) were found in the REML. Hydroxycarbamide and dasatinib were two registered drugs absent in all hospitals\' formularies. The market access for anticancer medicines was 73% (48 of 66). Semigovernment hospital (86%) has the highest availability, followed by the government hospital (80%). All the hospitals have unregistered drugs including bortezomib, lenalidomide, and mesna.
CONCLUSIONS: Pakistan\'s NEML adopts WHO EML abruptly but all medicines are not registered. The hospitals are trying their best to increase availability but optimum drug regulations to revise NEML based on the country\'s requirements and emphasizing registration of anticancer medicines are needed to improve the country\'s availability of antineoplastic agents.
METHODS: An observational study design was used in which antineoplastic drugs from the 2021 NEML and REML were compared with 2021 WHO EML to evaluate their availability in Pakistan. Market access was determined. Moreover, the formularies of six different hospital types were compared with each other and with the NEML, and REML to estimate the availability within hospitals.
RESULTS: There were 66 anticancer drugs in 2021 WHO EML and all were found in Pakistan\'s 2021 NEML but only 48 drugs (73%) were found in the REML. Hydroxycarbamide and dasatinib were two registered drugs absent in all hospitals\' formularies. The market access for anticancer medicines was 73% (48 of 66). Semigovernment hospital (86%) has the highest availability, followed by the government hospital (80%). All the hospitals have unregistered drugs including bortezomib, lenalidomide, and mesna.
CONCLUSIONS: Pakistan\'s NEML adopts WHO EML abruptly but all medicines are not registered. The hospitals are trying their best to increase availability but optimum drug regulations to revise NEML based on the country\'s requirements and emphasizing registration of anticancer medicines are needed to improve the country\'s availability of antineoplastic agents.
摘要：
目的：缺乏用于治疗和支持目的的抗癌药物是中低收入国家生存率低的关键原因。这项研究旨在分析国家基本药物清单（NEML）和注册基本药物清单（REML）是否与世界卫生组织（WHO）基本药物清单（EML）一致，以及该国流行的处方是否相互平行。
方法：使用观察性研究设计，将2021年NEML和REML的抗肿瘤药物与2021年WHOEML进行比较，以评估其在巴基斯坦的可用性。市场准入已经确定。此外，六种不同医院类型的处方进行了相互比较，并与NEML进行了比较，和REML来估计医院内的可用性。
结果：在2021年有66种抗癌药物WHOEML，全部在巴基斯坦的2021年NEML中发现，但在REML中只发现了48种药物（73％）。羟基脲和达沙替尼是所有医院处方中没有的两种注册药物。抗癌药物的市场准入为73％（66个中的48个）。中央政府医院（86％）的可用性最高，其次是政府医院(80%)。所有医院都有未经注册的药物，包括硼替佐米，来那度胺,还有Mesna.
结论：巴基斯坦的NEML突然采用WHOEML，但所有药物均未注册。医院正在尽最大努力增加可用性，但需要根据国家的要求修改NEML的最佳药物法规，并强调抗癌药的注册，以提高国家抗肿瘤药的可用性。
方法：使用观察性研究设计，将2021年NEML和REML的抗肿瘤药物与2021年WHOEML进行比较，以评估其在巴基斯坦的可用性。市场准入已经确定。此外，六种不同医院类型的处方进行了相互比较，并与NEML进行了比较，和REML来估计医院内的可用性。
结果：在2021年有66种抗癌药物WHOEML，全部在巴基斯坦的2021年NEML中发现，但在REML中只发现了48种药物（73％）。羟基脲和达沙替尼是所有医院处方中没有的两种注册药物。抗癌药物的市场准入为73％（66个中的48个）。中央政府医院（86％）的可用性最高，其次是政府医院(80%)。所有医院都有未经注册的药物，包括硼替佐米，来那度胺,还有Mesna.
结论：巴基斯坦的NEML突然采用WHOEML，但所有药物均未注册。医院正在尽最大努力增加可用性，但需要根据国家的要求修改NEML的最佳药物法规，并强调抗癌药的注册，以提高国家抗肿瘤药的可用性。
