Rizky Amelia
A severe public health crisis is unfolding across Iran as an escalating combination of American sanctions, a tightening maritime blockade, and devastating military bombardments cripple the country’s pharmaceutical industry. Patients nationwide are finding it increasingly difficult to locate or afford both essential life-saving therapies and routine daily medications, leaving vulnerable populations exposed to growing health risks.
For ordinary citizens, the mounting crisis has drastically altered everyday treatment routines. In Tehran, 59-year-old resident Farah previously relied on a Swiss-manufactured prescription to manage her autoimmune disorder. Escalating costs and spotty availability eventually forced her to transition to a domestically manufactured alternative. Now, she expresses growing dread that even locally produced supplies will soon vanish from pharmacy shelves, leaving her without reliable access to the consistent formulation required to stabilize her condition.
The scale of the deficit has reached alarming levels throughout the healthcare system. According to Hadi Ahmadi, a spokesman for the Iranian Pharmacists Association, approximately 800 pharmaceutical products are currently experiencing nationwide shortages. Among these depleted supplies, roughly 90 drugs are classified as critical and life-saving. Ahmadi noted that half of the missing medications—some 400 treatments—are formulations that are typically manufactured directly inside Iranian facilities.
Compounding the scarcity, retail costs for available treatments have risen sharply. Reports from the state-run Mehr News Agency indicate that the price of gabapentin, an essential medication prescribed for nerve pain and epilepsy, has climbed by 220 percent over the preceding year. Common fever and pain relievers like acetaminophen have witnessed a 375 percent price jump, while the antibiotic amoxicillin and the antidepressant fluoxetine have surged by 285 percent and 100 percent, respectively. For diabetic patients requiring daily insulin maintenance, costs have multiplied up to six times within the same twelve-month period.
These pharmaceutical price shocks are taking place against a broader, punishing inflationary backdrop across the Iranian economy. The country currently contends with one of the steepest inflation rates globally, with official figures revealing that the price of essential food staples jumped by more than 123 percent year-on-year by August. Everyday household necessities, including cooking oil, have more than tripled in price, compounding the financial strain on families already struggling to cover urgent medical needs.
The current breakdown exposes vulnerabilities in Iran's long-standing strategy of domestic self-reliance. For years, Tehran has pursued aggressive self-sufficiency programs across strategic sectors, investing heavily to establish domestic production lines for active pharmaceutical ingredients, specialized fabrication machinery, and generic finished drugs. However, despite these sustained efforts, the pharmaceutical ecosystem remains fundamentally reliant on international supply chains for critical chemical precursors, advanced manufacturing hardware, and specialized treatments for rare conditions.
That reliance has run headlong into Washington's punitive "maximum pressure" campaign. While legal frameworks ostensibly provide humanitarian exemptions for medical supplies, comprehensive banking restrictions and logistical barriers have effectively paralyzed the financial channels needed to facilitate imports. Procuring overseas materials has consequently become exorbitantly expensive and operationally perilous for domestic manufacturers trying to maintain basic inventory.
The crisis has been acutely exacerbated by direct military action. Since the outbreak of the war involving the United States and Israel against Iran in February, targeted airstrikes have damaged or outright destroyed an estimated 44 domestic pharmaceutical and medical equipment enterprises. Iranian officials have reported that the conflict has also taken a direct toll on industry personnel, leaving approximately 50 manufacturing and healthcare workers dead or wounded.
Among the hardest-hit facilities was Tofigh Daru, a prominent pharmaceutical enterprise operating under the ownership of Iran's largest pension fund. Maryam Farahani, the company’s director of sales, confirmed that Israeli air raids successfully struck all of the firm’s active research and manufacturing lines. The destroyed units included infrastructure dedicated to synthesizing peptide compounds, narcotic active ingredients, and vital anticancer therapies.
Farahani emphasized that the company’s output directly served some of the most medically vulnerable demographics in the country, with its primary client base consisting of cancer patients and individuals battling chronic, debilitating illnesses. A significant portion of the medications formulated at the site were proprietary or exclusive within the domestic market, making their sudden disappearance especially disruptive for treatment centers.
The physical and institutional destruction at Tofigh Daru has created enormous recovery hurdles. Farahani noted that specialized production machinery procured over 26 years of operation was wiped out, along with central database networks and digital server infrastructure. She projected that even a partial reconstruction of the bombed facility would take at least two years and require tens of millions of dollars. To prevent an absolute shutdown, the company has rented external production lines while researchers attempt to manually reconstruct lost institutional data.
The targeting of the facility has sparked sharp international contention. The Israeli military maintained in late March that it struck Tofigh Daru because the enterprise allegedly acted as a key supplier of fentanyl to SPND, a research division linked to the Iranian Ministry of Defence, which Israel accused of utilizing the chemical for offensive chemical weapons research.
Tofigh Daru has categorically rejected those allegations. The manufacturer stated that its fentanyl production was restricted strictly to the citrate-salt chemical form, synthesized only in limited quantities to fulfill standard medical applications such as surgical anesthesia. Farahani also highlighted that the facility produced glatiramer acetate, an injectable therapy used to treat relapsing multiple sclerosis—a generic version of Copaxone, originally developed by Israeli firm Teva—bemoaning the fact that essential scientific development centers were being demolished.
Logistical gridlock has further crippled attempts by Iranian drugmakers to recover. A US-enforced naval blockade has disrupted maritime commerce through the vital Strait of Hormuz, while parallel sanctions have restricted air, rail, and overland transport corridors. Even as the pharmaceutical sector buckles under these compounding pressures, Iranian government officials continue to publicly downplay the severity of the situation, insisting that the national medicine industry will withstand the crisis and avoid complete collapse.
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