Medicine prices in Iran have surged and patients are struggling to find essential treatments. The shortages and cost spikes show how war and sanctions are deepening the country's economic pain.

Medication prices are rising sharply in Iran and some treatments are becoming harder to find, leaving patients and families struggling as a US blockade and tighter sanctions put pressure on the country’s pharmaceutical industry. Seven months into the war with the United States and Israel, some medicine prices have more than tripled, adding to the strain on households already facing higher food and goods prices, rising unemployment and a currency that this week hit a record low after losing half its value.

The conflict has become an economic endurance test. Iran has sought to push up global energy prices with attacks on oil shipping routes in the region, while the United States has tried to damage Iran’s economy by blockading its ports since June and imposing increasingly tough sanctions. Iran’s medicines sector is exposed because it depends heavily on imports. While there has so far been little sign of major shortages at hospitals, the pressures are increasingly visible at pharmacies.

Gholamreza Rahmani, a welder in Tehran, said he and his wife recently spent two days going from one pharmacy to another to fill prescriptions for four medicines for their 12-year-old daughter, who was suffering from stomach problems. “Each one would have one or two items, not all of them,” he said, adding that they could not find one of the medicines anywhere. The search also cost him two days’ wages because he could not go to work. “My daughter’s illness and the loss of income are like scissors, cutting from two sides,” he said.

According to official statistics, Iran makes more than 80 per cent of its medicines at home, but many of them depend on imported raw materials. Before the war, most medicines and pharmaceutical components entered the country by sea, but the American naval blockade has cut off shipping, Bahman Sabour of the Tehran Pharmacies Association told local media. Importers then turned to air cargo, which is more expensive, but that route has also come under pressure after new US sanctions on several Iranian airlines led to some international flights being halted.

US sanctions do not directly target medicines, but long-running financial sanctions have also affected the supply chain because international banks and companies often avoid transactions linked to Iran, said Reza Majdzadeh, a professor at the School of Health and Social Care at the University of Essex in England. “A medicine may be perfectly legal to sell to Iran, but a bank may refuse to process the payment,” he said. “A pharmaceutical or shipping company may simply decide that dealing with Iran is not worth the risk. ... The transaction is legal on paper, but it does not happen in the real world.”

The Iranian government has not said how much medicine production has fallen, but officials say airstrikes have damaged more than 40 pharmaceutical factories, including some making cancer treatments. Pharmacies facing cash shortages are also finding it hard to keep shelves stocked. Mohammad Jamalian, a member of parliament’s health committee, said insurance companies are as much as nine months behind on payments to pharmacies for drug coverage because of the “current situation”. Sabour said insurance companies owe pharmacies about USD 270 million.

State media has also reported that supplies are under extra strain because medicines are being smuggled to Afghanistan, Pakistan and Iraq, where prices are higher.

At pharmacies, the price rise has been severe. “The price of almost everything has gone up, in some cases doubling, quadrupling, or even increasing sixfold,” said Mina Mohammadian, a salesperson at a pharmacy in Tehran. Mehdi Pirsalehi, who heads the government agency that fixes drug prices, said last week that the prices of 2,000 types of medicines had been “amended” over the past six months because of inflation and currency problems.

Ali Fallah, a Tehran resident, said the ointment he buys for inflammation has risen fourfold in three months, from 750,000 rials, or about USD 0.35, to 3.25 million rials, or about USD 1.46. The minimum daily wage for an unskilled worker in Iran is about 7.5 million rials, or about USD 3.50. “I honestly don’t know where this situation is heading,” Fallah said. Tablets used by patients undergoing kidney dialysis have gone up by nearly 350 per cent in recent months. Over-the-counter painkillers such as acetaminophen have also risen sharply in price, when they are available at all.

The government appears to be prioritising hospital supplies, but some shortages have been reported there too. An employee at a public hospital said there were shortages of specialised psychiatric medicines used to treat bipolar disorder and acute psychosis, as well as more common medicines for anxiety and panic disorders. Doctors have had to use electro-convulsive therapy more often because the required drugs were either unavailable or of poor quality, she said. “The side effects for patients are really a lot,” she told The Associated Press by phone from a major Iranian city, speaking on condition that she and her location were not identified for security reasons.

Azita Hassanpour, a part-time teacher, said her mother, who has cancer, has been able to receive chemotherapy, but treatment is sometimes delayed because the medicines are not as easily available as they were before the war. She is also worried because her mother has not been able to get her annual flu shot as authorities try to find new sources of vaccines. “I am worried that I may lose her because of flu. I weep out of her sight every night,” Hassanpour said.

Hadi Ahmadi, a spokesman for the Iranian Pharmacists Association, told local media on Saturday that about 700,000 doses of flu vaccine had been imported from China and another 500,000 doses were expected soon. But this year’s shot is selling for 22 million rials, or about USD 9, almost double last year’s price, though authorities have said it will be given free to high-risk patients.

Across Iran, the pressure of war, sanctions and disruption to imports is showing most clearly in pharmacies, where medicines are costlier and harder to find even as hospitals continue to receive supplies in many cases. For patients and their families, the crisis is adding another burden to an already worsening economic situation. With PTI Inputs