Iran's Medicine Crisis: A Human Cost of Sanctions

Introduction

When Farah, a 59-year-old resident of Tehran, used to fill her autoimmune prescription with a Swiss-made drug, she never imagined the day would come when even the Iranian-made version might be scarce. That's the harsh reality unfolding across Iran, where economic warfare has created an escalating health emergency.

I've been tracking the ripple effects of international pressure on everyday life for years, and what I'm witnessing now is particularly sobering: a pharmaceutical sector under siege, leaving millions without access to life-saving medicines.

"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."

The Scope of the Crisis

Iranian authorities have acknowledged that about 800 pharmaceutical products are currently in short supply nationwide. Of those, 90 are classified as essential and life-saving, according to Hadi Ahmadi, a spokesman for the Iranian Pharmacists Association. Four hundred of these drugs are manufactured domestically, meaning Iran's own production capacity is struggling to meet basic needs.

But it's not just about availability—it's also about affordability. The price increases have been staggering. Gabapentin, used to treat epilepsy and nerve pain, has risen 220% over the past year. Acetaminophen, a common pain and fever reducer, is up by 375%. Amoxicillin, an antibiotic, has surged 285%, and Fluoxetine, an anti-depressant, by 100%. Insulin, a daily necessity for diabetics, now costs up to six times what it did a year ago.

This inflationary spiral is part of a broader economic crisis. Iran's inflation rate ranks among the highest globally, with essential food items up more than 123% year-on-year as of August. Cooking oil alone has tripled in price—clearly indicating that this isn't just a medical issue, but a systemic one.

History and Self-Sufficiency Efforts

Iran has long pursued self-sufficiency in medicine, as it has in other industries, building domestic capacity to manufacture active pharmaceutical ingredients, equipment, and finished drugs. Yet the sector still heavily relies on imports for critical ingredients, equipment, and rare medications.

The damage began years ago with Washington's "maximum pressure" sanctions that targeted financial and logistics networks facilitating medical procurement. Despite existing humanitarian exemptions, these measures have significantly increased costs—creating a cascade effect that has only worsened since the conflict between the U.S. and Israel escalated in February 2026.

Since then, more than 44 pharmaceutical and medical equipment companies have been destroyed or damaged, according to Iranian officials. Some 50 industry workers were killed or wounded during these attacks—a loss of human capital that's particularly devastating for a sector reliant on specialized knowledge.

Case Study: Tofigh Daru

One of the most significant blowouts occurred at Tofigh Daru, Iran's largest pharmaceutical company, owned by the country's biggest pension fund. Israeli air strikes destroyed all of its research and production lines—including those making peptide and narcotic active ingredients as well as anticancer drugs.

Maryam Farahani, the company's director of sales, told me that they had lost databases, server sites, and specialized equipment bought over 26 years. Rebuilding would take at least two years and tens of millions of dollars—while researchers try to salvage institutional knowledge lost in the destruction.

The Israeli military accused Tofigh Daru of supplying fentanyl to SPND, a Ministry of Defence research body allegedly using it for chemical weapons research. However, Tofigh Daru has disputed this claim, stating that they only produced the citrate-salt form of fentanyl, in small quantities, for approved medical uses like surgical anesthesia.

Farahani also highlighted another blow: the company was once a leading manufacturer of glatiramer acetate, an injectable drug used to treat multiple sclerosis. This loss is especially poignant given that the original version—Copaxone—was developed by Teva and long dominated the global market before generics emerged.

Official Response vs. Reality

Despite these grim developments, Iranian authorities have sought to project resilience. Mahdi Pirsalehi, head of Iran's Food and Drug Administration, said the pharmaceutical industry is refusing to collapse under pressure during a recent B2B exhibition in Tehran.

He claimed there were fewer drug shortages than last year—but provided no data to back that assertion. What's clear is that even the most optimistic projections pale in comparison to what ordinary citizens are experiencing on the ground.

Doctors and health professionals are increasingly alarmed. A gastroenterologist and university professor, who spoke anonymously due to sensitivity around the topic, described the price hikes as "staggering" and said they had become an insurmountable barrier for many vulnerable Iranians.

She noted that the government's gradual removal of subsidized foreign currency for medical imports, combined with quadrillions in unpaid debts insurers owe pharmacies, has further compounded the crisis. The debt totals around 8 quadrillion rials ($3.56 billion), a staggering sum that reflects both the scale of mismanagement and international pressure.

Public Health Implications

The implications extend far beyond individual patients. Vaccines are particularly at risk. Reports indicate that rotavirus vaccine imports have already been halted due to maritime blockades, and influenza vaccines may soon face the same fate.

This poses a serious threat to nationwide efforts to prevent vaccine-preventable communicable diseases—a situation that could quickly escalate into a public health catastrophe. The consequences for vulnerable groups—infants, children, pregnant women—are especially alarming.

"Runaway inflation, poverty, and inadequate access to essential food groups among vulnerable populations... signal the onset and spread of malnutrition," the doctor explained. "Consequently, this raises the risk of both communicable and non-communicable diseases, creating a vicious cycle in which malnutrition develops and progressively worsens."

Conclusion: The Human Toll of Economic Warfare

What we're seeing in Iran isn't just another economic crisis—it's a human one. When people can't afford basic medications or access clean water and nutritious food, the results are not only medical but societal. It's a stark reminder that markets don't operate in isolation; they reflect the choices made by nations, and the lives affected by those choices.

Sanctions often aim to weaken an economy from afar—but when those policies directly affect medicine and food supplies, they become instruments of harm. In Iran, we're watching that harm manifest in real time, with real consequences for real people. As global leaders debate trade wars, it's crucial not to lose sight of how these decisions impact the lives of ordinary citizens.

That's why understanding the full picture matters—especially when policy choices have the power to shape health outcomes for generations to come.