Iran's pharmaceutical sector is buckling under the combined weight of a seven-month war with the United States, sweeping sanctions, and a naval blockade, leaving the country short of hundreds of medicines. Basic drugs such as paracetamol and insulin have seen price hikes of up to sixfold, while rarer treatments have vanished from shelves altogether.
According to Iranian media, roughly 90 of the unavailable drugs are classified as essential or life-saving. Hadi Ahmadi, spokesperson for the Iranian Pharmacists Association, told domestic outlets last week that around 400 of the scarce medicines are produced locally—a sign that domestic manufacturing has not shielded the sector from disruption, as many producers depend on imported raw materials.
Ruhollah Lak Aliabadi, a member of parliament's health commission, told the Tabnak news site that problems accessing imported inputs are directly causing production and distribution failures. Vahideh Mahmoudkhani, head of the health department at Iran's trade centre in Shanghai, told the newspaper Hamshahri that the war has completely shut down some supply routes and made others significantly longer. "Even some medicines that have run out are stuck in transit," she said.
Sanctions and blockade strangle supply chains
Although medicines and humanitarian goods are typically exempt from direct sanctions under international law, banking restrictions, difficulties transferring foreign currency, and blockade-related transport disruption prevent Iranian companies from purchasing drugs and raw materials abroad, regardless of their formal legal status. The US naval blockade of Iranian ports and cargo vessels, imposed in April, was briefly lifted following a framework agreement but reinstated after talks collapsed. In late August, Washington launched Operation Economic Outcast, designed to further restrict Tehran's access to international financial networks.
Mehdi Pirsalehi, head of Iran's Food and Drug Organisation, said on Tuesday that 44 companies in the medicines and medical equipment sector had been targeted in attacks since the war began, with staff killed and wounded. He made the remarks at the opening of a pharmaceutical exhibition in Tehran, while stressing that two companies struck directly by several missiles were present at the event and had resumed production.
One of those companies was Tofigh Daru. In late March, Israeli officials announced they had struck it because of what they said was its role in supplying fentanyl to a research body within Iran's defence ministry. Tofigh Daru rejected the allegation, saying it produced only fentanyl citrate in limited quantities and exclusively for authorised medical uses including surgical anaesthesia.
Prices spiral beyond reach
The physical shortage of medicines is compounded by price rises that are pricing patients out of treatment. Mehr state news agency has reported that gabapentin—used to treat epilepsy and nerve pain—rose 220% in price over a year. Paracetamol rose 375%, amoxicillin 285%, and fluoxetine 100%. Insulin, which diabetic patients require daily, has in some cases reached six times last year's price. The continued depreciation of the rial on the open market is feeding further price increases across the sector.
Salman Es'haghi, a member of parliament's health commission, said more than 70% of healthcare costs in Iran are paid directly out of patients' pockets. Ahmad Ariayi Nejad, also on the commission, said the financial pressure was already showing in fewer patients attending clinics and doctors' surgeries. He cited the case of a labourer and tenant who needs two injections a month costing approximately 74 million tomans—a sum that amounts to several months' wages for many Iranians.
The consequences are most acute for patients with serious conditions. When treatment for heart disease or cancer is interrupted or delayed for financial reasons, the harm is often irreversible. "Some people, because of economic hardship and lack of financial means, abandon their treatment part-way through," Ariayi Nejad said.
The crisis in Iran's pharmaceutical sector is a stark reminder of how war and sanctions can devastate civilian infrastructure, even in areas nominally protected by international law. As the conflict drags on, the human cost continues to mount, with the most vulnerable bearing the brunt.
