Nasser Karimi & Amir-Hussein Radjy

Medicationprices are soaring in Iran and some treatments have become hard to find, leaving patients and their families scrambling as a US blockade and stepped-up sanctions squeeze the country's pharmaceuticals industry. Some medicines have more than tripled in price, further squeezing Iranians' finances seven months into the country's war with the United States and Israel. Prices for food and other goods have skyrocketed even as unemployment has risen and the currency, which hit a record low this week, has lost half its value.

The war has become an economic endurance test. Iran has tried to push world energy prices higher with attacks on the region's oil shipping routes; the United States, in turn, has aimed to wreck Iran's economy by blockading its ports since June and slapping it with increasingly tough sanctions.

Iran's pharmaceutical industry is vulnerable because of its reliance on imports. So far there has been little sign of major shortages of medicines at Iran's hospitals, but the difficulties are showing at pharmacies. Gholamreza Rahmani, a Tehran welder, and his wife recently scoured several pharmacies over two days hoping to fill prescriptions for four medicines for their 12-year-old daughter, who was having stomach troubles. “Each one would have one or two items, not all of them,” he said, noting that they couldn't find one of the medicines anywhere. The search cost him two days of wages because he couldn't go to work.

“My daughter's illness and the loss of income are like scissors, cutting from two sides,” he said.

Iran's pharmaceutical industry needs imports

Iran produces more than 80 per cent of its medicines domestically, according to official statistics, but many of those rely on imported raw materials. Before the war, most medicines and pharmaceutical components were brought in by sea, but the American naval blockade has cut off shipping, Bahman Sabour, a member of the Tehran Pharmacies Association, told local media.Medical importers switched to more expensive air routes. But that access has been threatened by new US sanctions on a number of Iranian airlines, which led to some international flights being halted.

U.S sanctions don't directly target medicines, but financial sanctions in place for years also hurt the pharmaceutical supply because international banks and companies often will be overly cautious and refuse transactions because they fear running afoul of sanctions, 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 hasn't said how much medicine production has fallen. But officials say it has been hurt because airstrikes damaged more than 40 pharmaceutical factories, including some producing cancer treatments.

Also, cash-strapped pharmacies sometimes struggle to keep their shelves stocked. Insurance companies have fallen behind by as much as nine months on payments to pharmacies for drug coverage because of the “current situation,” said Mohammad Jamalian, a member of parliament's health committee.

Sabour, of the pharmacies' association, said insurance companies owe pharmacies about $270 million.

Supplies are also strained because medicines are smuggled to neighboring Afghanistan, Pakistan and Iraq, where prices are higher, state media reported.

Pharmacy prices are spiking

“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, head of the government agency that sets drug prices, said last week that the prices of 2,000 types of medicines were “amended” over the past six months because of inflation and currency issues.

Ali Fallah, a Tehran resident, said the ointment he buys for inflammation has quadrupled in price in three months — from 750,000 rials, or about $0.35, to 3.25 million rials, or roughly $1.46. The minimum daily wage for an unskilled worker in Iran is about 7.5 million rials, or about $3.50.

“I honestly don't know where this situation is heading,” Fallah said.

Tablets essential for patients undergoing kidney dialysis, for example, have climbed by nearly 350 per cent in recent months. So have over-the-counter painkillers like acetaminophen, if it can be found at all.

The government appears to be ensuring hospitals are supplied

An employee at one public hospital said there are shortages of key specialized psychiatric medicines to treat bipolar disorders and acute psychosis, and more common medications for anxiety and panic disorders. Doctors have had to use electro-convulsive therapy on patients more often because the relevant drugs weren't available or were of inferior quality, she said. “The side effects for patients are really a lot,” she told The Associated Press by phone from a major Iranian city. She spoke on condition that she and her location would not be identified for security reasons.

Azita Hassanpour, a part-time teacher, said that her mother, who has cancer, has been able to get her chemotherapy treatments, but sometimes they are delayed because the medicines aren't as available as they were before the war. Hassanpour is also concerned because her mother hasn't been able to get her annual flu shot, with authorities trying to track down new vaccine sources.

“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 of the Iranian Pharmacists Association, told local media Saturday that about 700,000 flu vaccine doses were imported from China and another half million doses are expected soon. But a jab this year is going for 22 million rials, or roughly $9, which is almost double last year's price, though authorities have promised to provide it to high-risk patients free of charge.

Printed and Published by K. Hanumanta Rao on behalf of Hyderabad Media House Private Limited 8-2-268/1/A/2/8, Plot No. 3, Aurora Colony, Road No.3, Banjara Hills, Hyderabad - 500034 and Printed at Aamoda Press, H.No. 5-9-287/10 & 11, Plot No. 53 & 54, Prashanth Towers, Rajeev Gandhi Nagar, Moosapet, Kukatpally(M), Kukatpally Municipality, Medchal-Malkajgiri District. Chief Editor: P Madhusudhan Reddy. RNI No: TELENG/2023/86916