Iran is grappling with widespread medicine shortages, impacting approximately 800 pharmaceutical products nationwide, 90 of which are considered essential and life-saving. This crisis is exacerbated by ongoing US sanctions, a naval blockade, and the recent war, which has damaged or destroyed 44 pharmaceutical and medical equipment companies and killed or wounded 50 industry workers. Even domestically manufactured medicines, accounting for 400 of the scarce drugs, are affected as local producers rely heavily on imported raw materials.
The cost of medicines has surged dramatically, with gabapentin, used for epilepsy and nerve pain, rising 220% over the past year. Acetaminophen and Amoxicillin have seen price increases of 375% and 285% respectively, while the antidepressant Fluoxetine has risen by 100%. Insulin, a daily necessity for diabetics, now costs up to six times what it did a year ago, with some patients seeing out-of-pocket costs rise more than 24-fold. This is further complicated by the government's removal of subsidized foreign currency for medical imports and $3.56 billion in unpaid debts from insurers to pharmacies.
While medicines and humanitarian goods are typically exempt from direct sanctions, banking restrictions, difficulties in transferring foreign currency, and disruption to transport routes—including a naval blockade impacting shipping through the Strait of Hormuz—have severely hampered Iran's ability to procure critical medical imports. This has led to significantly higher costs and a slowdown in money transfers. Hadi Ahmadi of the Iranian Pharmacists Association stated that alternative routes for raw materials and imports could increase drug costs by up to three times.
The health sector requires an estimated $2.2 billion in foreign currency for medicines and raw materials this year, but only about half of this amount has been supplied. More than 70% of healthcare costs in Iran are now paid directly out of patients' pockets, making treatment inaccessible for many vulnerable individuals. Concerns are growing about the availability of vaccines, with reports of halted rotavirus vaccine imports due to the maritime blockade and potential shortages for influenza vaccines.
Despite these challenges, Iranian authorities, including Mahdi Pirsalehi, head of Iran's Food and Drug Administration, have attempted to project resilience, accusing adversaries of trying to "denigrate" Iran's conditions through media. However, doctors in Tehran express grave concerns about the threat to public health from these shortages and the staggering price increases, which are becoming an insurmountable barrier for many. The current situation highlights Iran's dependence on imported critical ingredients, equipment, and rare medications despite its efforts towards self-sufficiency in medicine.
