MS patients in K-P struggle to continue treatment without Sehat Card coverage

Patients with multiple sclerosis (MS) in Khyber-Pakhtunkhwa (K-P) are being forced to interrupt or discontinue treatment, as the provincial Sehat Card Plus programme does not cover the debilitating neurological disease, which primarily affects young adults and can cause long-term disability.

Patients and healthcare advocates said the lack of financial support was leaving families struggling to meet the cost of disease-modifying therapies, which are essential for controlling relapses and slowing the progression of MS.

According to healthcare experts, MS is a chronic autoimmune disease in which the immune system attacks the central nervous system. Although there is no known cure, timely and continuous treatment can help reduce relapses and slow disease progression. They warned that interruptions in treatment could have serious consequences for patients and may eventually increase their dependence on healthcare and social support services.

A 2025 analysis of Global Burden of Disease data estimated Pakistan’s age-standardised MS prevalence at 9.80 per 100,000 people in 2021, up from 8.34 in 1990, with women recording a substantially higher rate of 12.31 per 100,000 compared with 7.38 among men. The analysis reported an annual increase of 0.38% in MS prevalence in K-P.

Sehat Sahulat Card Project Director Dr Riaz Tanoli, however, said the major obstacle to including MS in the programme was the exceptionally high cost of its treatment. He said the annual cost of treating an MS patient could range between Rs800,000-900,000, making it financially difficult to incorporate the disease into the existing health card package.

Dr Tanoli said the government had considered the issue and that he had prepared a proposal for including MS treatment in the programme. However, he said financial constraints prevented the proposal from being incorporated into the health card scheme. “I prepared a proposal in this regard, but due to financial constraints, it could not be included in the programme,” he stated.

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The official said the government had to consider the sustainability of any treatment package before including a disease in the health insurance programme. “If you start coverage for a disease whose treatment cost you cannot sustain for one year, it does more harm than good,” he said.

Dr Tanoli added that the exclusion was not unique to K-P, arguing that MS treatment was also not covered under social insurance schemes elsewhere in Pakistan despite the government bearing the cost of such programmes. However, it must be mentioned that the health card programme in Punjab partially covers MS treatment up to Rs400,000, while the Balochistan government launched an initiative in 2025 providing free-of-cost treatment for 125 patients.

“Neurological disorders requiring neurosurgery are covered under the Sehat Card, but we plan to include non-surgical neurological disorders in the agreement from the coming year,” Dr Tanoli said.

However, he clarified that the planned expansion would not necessarily bring MS treatment under the health card. He said the programme's current treatment package was capped at Rs1 million, while some MS medicines could cost between Rs300,000 and Rs400,000 for a single dose, making comprehensive coverage difficult within the existing financial limits.

The official noted that the government had nevertheless kept a special mechanism for financially vulnerable patients who could not afford expensive treatment. According to him, cases involving such patients could be referred to the government for special approval.

Dr Tanoli stated that a summary is sent to the Finance Department, after which the cabinet approves the assistance.

He also identified another major challenge for MS patients, saying that medicines used for treating the disease were not readily available in Pakistan. The limited availability of medicines, combined with their high cost, further complicated access to continuous treatment, particularly for patients from low-income households.

Healthcare advocates have urged the provincial government to move beyond case-by-case assistance and establish a sustainable mechanism for MS treatment under the public healthcare system. They argued that leaving patients dependent on individual approvals was not a long-term solution for a chronic disease requiring continuous treatment.