Britain could be “weeks away” from drug shortages if the Iran war continues, experts say

Britain is “weeks away” from shortages of medicines ranging from painkillers to cancer treatments if the Iran war continues, experts say, while drug prices could also rise.

The conflict has disrupted the supply of countless critical raw materials, including oil, gas, crop fertilizers and helium — and health needs may be next.

David Weeks, director of supply chain risk management at analyst group Moody’s in Texas, said: “It’s a perfect storm, we have the conflict in the Gulf that led to the closure of the Strait of Hormuz, and India is known as the pharmaceuticals of the world. They produce a lot of generics. [off-patent] Drugs and APIs [active pharmaceutical ingredients]. With the geopolitical situation, it is difficult and difficult to get out of it.”

Airports in Dubai, Doha and Abu Dhabi were initially closed and are now operating on a limited schedule, with pharmaceutical companies having to shift their shipments by air, and some now relying on sea transport, lengthening travel times.

Due to the almost complete closure of the Strait of Hormuz, shipping – the main route for many drugs – is also under pressure.

“We’re not in crisis at the moment but it’s still a serious situation,” said Mark Samuel, chief executive of Medicines UK, which represents manufacturers of cheaper, off-patent medicines known as generics, which make up 85% of drugs used by the NHS.

He said that if the war continues, there may be a shortage of drugs in a few weeks. Medical distributors usually stock six to eight weeks to avoid shortages; Whereas suppliers to hospitals in the UK must have eight weeks’ worth.

During the Covid pandemic, paracetamol and other painkillers were in short supply in the UK and elsewhere, as drugmakers in India – which produces 60% of the generic drugs used worldwide and half of what the US needs – struggled to keep up with demand.

The UK manufactures around a quarter of its medicines domestically, while a third comes from India and a third from the EU.

The US-Israel war against Iran has doubled the cost of air freight. “One of the NHS medicines comes through the air, and at the moment manufacturers are trying to absorb those costs,” Samuels said. “But they have historically had low margins, and the risk is that it hurts some medicines to get to the NHS.”

While suppliers have long-term pricing agreements with NHS hospitals, they have a monopoly on drugs supplied to GP practices and pharmacies, where they can raise prices.

For now, drug supplies are “not disrupted, but disrupted,” said Voter Dewulf, a professor at the Antwerp School of Management and an expert in pharma logistics. He expects drug manufacturers to pass on higher costs through price hikes if the situation worsens. “Everything depends on how long the war lasts,” he added.

Frank Van Gelder, healthcare and pharmaceutical supply chain strategist and pharma. Chaos in the Middle East air corridor has hit the drug sector hard because of its reliance on frequent flights, said the secretary-general of the non-profit group Aero. Before the war, about 3,700 passenger flights – which also carry cargo – were flown into the region’s airports each day.

Air cargo levels fell 80% earlier this month and are still falling sharply.

Some drugs must be transported by air for speed, including: expensive treatments for cancer and infectious diseases; high-tech cell and gene therapies; Biologicals with live materials that require cold storage; and drugs used in clinical trials.

DeWulf noted that healthcare cargo will always be prioritized over items from e-commerce. Transport by sea is an alternative to stable, common medicine but because the ship must travel around the Cape of Good Hope, it adds 14 days to the journey and another $1 million (£750,000) in fuel costs.

In addition to higher transportation costs, rising crude oil and natural gas prices affect the cost of petrochemical products such as methanol and ethylene, which are needed to make APIs, key pharmaceutical ingredients, as well as syringes, glasses, tubes, jewelry, and glasses.

“So the industry, and in this case the life sciences and the pharma industry, has a significant impact,” Van Gelder said. He said it would ultimately be the patient who picks up the tab, either directly or through public health systems such as the NHS, which are ultimately funded by the taxpayer. “So in the end we all pay more, right?”