Karachi: In a disturbing revelation, government hospitals across Sindh continue to purchase near-expiry medicines in violation of established procurement protocols, allegedly to cut costs and exploit price differences between short and long shelf-life drugs.

Health experts have raised serious concerns over this unethical procurement practice, revealing that medicines nearing expiry are significantly cheaper, often making them a financially attractive—yet dangerous option for public institutions. Each year, allegations surface regarding irregularities worth billions of rupees in Sindh’s pharmaceutical procurement system, yet little systemic reform has been seen.

According to pharmaceutical experts, these purchases are strategically and technically orchestrated in such a way that proving malpractice becomes increasingly difficult. “Medicines close to their expiration date are considerably cheaper than those with a longer shelf life. That’s where the profit is made,” a senior pharmacologist explained.

The central procurement of medicines in Sindh is overseen by the Central Procurement Committee (CPC), which handles around 75% of hospital pharmaceutical purchases. The remaining 25% is handled by hospitals and district health offices under the “Local Purchase” model. The CPC also sets the pricing structure for drugs procured across public health institutions.

Tenders for drug procurement are issued based on generic formulations (chemical names) rather than branded trade names. This allows lesser-known pharmaceutical companies to secure contracts based on lower pricing. These generic-based purchases are then mandated across multiple hospitals at the same rate, often sidelining quality in the name of cost-effectiveness. Meanwhile, these very drugs are sold under brand names in the open market—highlighting a dangerous disconnect between procurement practices and retail standards.

Under Drug Regulatory Authority of Pakistan (DRAP) policy, hospitals are only supposed to purchase medicines with a minimum remaining shelf life of six months to one year. However, the absence of a centralized monitoring mechanism allows violations to persist unchecked. There is no comprehensive system in place to track and enforce compliance across procurement cycles.

Pakistan’s existing Drug Act 1976 and the DRAP Act 2012 clearly stipulate severe penalties for supplying or distributing expired medicines, including fines, cancellation of drug licenses, and imprisonment of up to five years. Yet, public health experts say implementation remains weak, especially at the provincial level.

Another significant shortcoming is the absence of a national pharmacopoeia—a standardized reference for drug formulations. Currently, Pakistan has 900 registered pharmaceutical formulations, of which 400 are classified as Essential Medicines, while 500 fall under Non-Essential categories. The lack of pharmacopoeia means there’s little standardization in medicine testing and quality control.

Speaking on the matter, Dr. Obaid Ali, head of DRAP’s Sindh operations, confirmed that the price gap between near-expiry and long-shelf-life medicines is substantial. He acknowledged that many public hospitals prefer short-shelf-life drugs due to their lower costs, despite the risk. “The efficacy of a medicine decreases as it nears expiry, although technically it can still be used safely before that date,” he explained.

Dr. Obaid added that while expired drugs are legally unsafe and prohibited, medicines nearing expiry are not explicitly banned if used before their expiration. However, this gray area continues to be exploited under the guise of cost efficiency.

The issue recently caught the attention of the Public Accounts Committee (PAC) of the Sindh Assembly, which held a review session chaired by Chairman Nisar Khuhro. Questions were raised over the transparency and efficacy of the procurement mechanism. In response, Health Secretary Rehan Iqbal Baloch assured the committee that all procurements are carried out through a merit-based tender system under CPC guidelines.

In a statement to The Express Tribune, Secretary Baloch reiterated that the provincial health department follows CPC directives when purchasing medicines for public hospitals, and claimed that the procurement process is transparent and in compliance with legal protocols.