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Express withdrawal is available for freelancer.com's freelancers in Pakistan. Through this option, the payments can be transferred to your local bank account free of cost. To avail this option, you must have a valid bank account, IBAN to your name. First withdrawal will take 15 days to clear security matters. After that, you will receive the payment into your account without any deductions from third parties.

You can simply use your Debit card or Credit card. They can charge only 35 to 40 PKR for this. Skrill and Payoneer option you can also use.

You can use Skrill or Payoneer.

I have a similar problem as i am in Lebanon. So you need to either find a trustworthy person outside Pakistan to receive your payments through paypal and then send it to you. Or you can create a bank account and the money will be sent to it (i tried and it works but just takes abit longer and there is a higher fees)