Iran Medicine Crisis Deepens: 800 Drugs In Short Supply As War Damage, US Sanctions Hit Supplies

Iran’s medicine shortage is deepening as rising prices, damaged pharmaceutical facilities and disruptions to imports leave patients struggling to obtain both essential and everyday drugs. Iranian officials maintain that the country’s pharmaceutical sector remains resilient despite the mounting pressure.

According to Al Jazeera, Hadi Ahmadi, a spokesman for the Iranian Pharmacists Association, said around 800 pharmaceutical products were currently in short supply nationwide, including 90 considered essential and life-saving. About 400 of the medicines in short supply, he said, are manufactured inside Iran.

The shortages are being reported alongside sharp increases in medicine prices, with patients facing growing difficulties in paying for treatment. The pressure on Iran’s pharmaceutical sector has intensified amid US sanctions, military action and a naval blockade that have disrupted supply routes and increased the cost of imports.

Patients turn to domestic alternatives

For Farah, a 59-year-old Tehran resident, the shortage has already changed the way she manages her autoimmune condition. She previously relied on a Swiss-made medicine but has switched to an Iranian-made version because it is cheaper and easier to find.

“I switched to the Iranian-made version because of the price and availability,” she told Al Jazeera, giving only her first name. “You might not find the foreign-made version later, and you can’t keep switching because they don’t have the same quality and effectiveness.”

She is now concerned that the Iranian-made medicine could also become difficult to obtain.

Iranian news outlets have reported shortages of medicines used to treat cancer and other serious illnesses as problems across the pharmaceutical industry grow. The crisis comes as the United States applies military pressure, sanctions and a naval blockade as part of efforts to squeeze Iran.

Prices have also risen substantially. Mehr News Agency reported last week that gabapentin, which is used to treat epilepsy and nerve pain, has become 220 per cent more expensive over the past year. Acetaminophen, used for pain and fever, has increased by 375 per cent, while amoxicillin has risen by 285 per cent and fluoxetine by 100 per cent.

Insulin, which many diabetics require every day, now costs as much as six times its price a year ago.

The medicine price increases are taking place against a wider inflation crisis. The cost of essential food items in Iran was more than 123 per cent higher year-on-year in August, while some staples, including cooking oil, had more than tripled in price.

War damage adds to supply pressures

Iran has spent years expanding domestic pharmaceutical production as part of its wider drive for self-sufficiency. The country produces active pharmaceutical ingredients, medical equipment and finished medicines, but remains dependent on imports for several critical ingredients, specialised equipment and rare drugs.

US sanctions have also affected the financial and logistical systems needed to bring medical supplies into the country. Despite humanitarian exemptions, Washington’s years-long “maximum pressure” campaign has made medical imports more expensive and complicated procurement.

The situation deteriorated further after the US-Israel war on Iran began in February. Al Jazeera reported that the conflict damaged or destroyed about 44 pharmaceutical and medical equipment companies, while Iranian officials said around 50 industry workers were killed or wounded.

One of the companies hit during the conflict was Tofigh Daru, which is owned by Iran’s largest pension fund.

Maryam Farahani, the company’s director of sales, told Al Jazeera that Israeli air strikes hit all of its research and production lines, including facilities manufacturing peptide and narcotic active ingredients and anticancer medicines.

“Our target audience are predominantly cancer patients and people with chronic diseases,” Farahani said. “Some of the medicine we used to produce were exclusive.”

Tofigh Daru has since rented an alternative production line to maintain some level of output, Farahani said. However, she added that US sanctions and the naval blockade have increased import costs by restricting shipping through the Strait of Hormuz and disrupting air, rail and overland routes.

Farahani said databases and server sites were destroyed in the strikes, along with specialised equipment acquired during the company’s 26 years of operation. She estimated that partially rebuilding the facility would take at least two years and cost tens of millions of dollars.

In the meantime, researchers are working to preserve institutional knowledge that was lost when the company’s data was destroyed, she said.

The Israeli military said in late March that Tofigh Daru was targeted because it was a principal supplier of fentanyl to SPND, a Ministry of Defence research body. Israel accused SPND of using the drug in chemical weapons research.

Tofigh Daru has rejected that explanation, saying it produced only the citrate-salt form of fentanyl, in small quantities, for approved medical purposes such as surgical anaesthesia.

Farahani also said the company produced glatiramer acetate, an injectable medicine used to treat relapsing forms of multiple sclerosis. Copaxone, the original version of the drug, was developed and marketed by Israeli pharmaceutical company Teva before generic alternatives were produced elsewhere.

“It is truly regrettable that many of the places targeted across Iran were research sites, and what leads to the development of a country,” she said.

Tehran insists pharmaceutical sector can cope

Iranian authorities have sought to counter reports of a worsening pharmaceutical crisis, arguing that the sector is continuing to function despite the pressure.

“The enemy has identified medicine as one of the sensitive areas of the country, and is trying to denigrate and portray Iran’s conditions as unfavourable by releasing content in the press and social media,” Mahdi Pirsalehi, head of Iran’s Food and Drug Administration, said on Tuesday.

Pirsalehi was speaking at the opening of a three-day pharmaceutical exhibition at Tehran’s Iran Mall. He said Iran was experiencing fewer medicine shortages than it did last year, but did not provide figures to substantiate the claim.

Two major pharmaceutical companies damaged by US and Israeli strikes, including Tofigh Daru, were among those taking part in the B2B exhibition, Pharmex. The event was attended mainly by Iranian companies, although representatives from a small number of Chinese and other businesses were also present.

Doctors, however, remain concerned about the effect of medicine shortages and rising costs on public health.

A Tehran-based gastroenterologist and university professor, speaking anonymously, described the recent increase in medicine prices, including domestically produced generic drugs, as “staggering”. She said the higher costs had become an insurmountable barrier for many vulnerable Iranians.

She attributed part of the pressure to the government’s gradual removal of subsidised foreign currency for medical imports, as well as large unpaid debts owed by insurers to pharmacies. Iranian media has put those debts at around 8 quadrillion rials ($3.56bn).

The doctor also raised concerns over access to vaccines. She said reports that rotavirus vaccine imports had been halted because of the maritime blockade, along with the possibility that influenza vaccine imports could face similar disruption, posed a threat to vaccination efforts.

“Reports that rotavirus vaccine imports have been halted because of the maritime blockade – and that influenza vaccines may soon face the same problem – represent a serious and alarming threat to nationwide efforts to prevent vaccine-preventable communicable diseases,” she said.

She also warned that shortages of medicine were unfolding alongside worsening food insecurity and poverty, increasing risks for vulnerable groups including infants, children and pregnant women.

“Runaway inflation, poverty, and inadequate access to essential food groups among vulnerable populations, including infants, children, and pregnant women, signal the onset and spread of malnutrition,” she said. Consequently, this raises the risk “of both communicable and non-communicable diseases, creating a vicious cycle in which malnutrition develops and progressively worsens”, she added.