What the Iran war could mean for pharmaceuticals

While Britain’s National Health Service has warned that the country is just “weeks away” from drug shortages linked to the war in Iran, pharma experts say the US is in a more stable position. At least for now.

In response to US and Israeli attacks that began at the end of February, Iran closed the Strait of Hormuz, a waterway that’s important to many global supply chains and that roughly one-fifth of the world’s oil supply passes through. The global pharmaceutical supply chain relies on the petroleum that moves through the strait to manufacture medicines.

However, David Warrick, EVP of enterprise at supply chain risk management firm Overhaul, told Healthcare Brew the US has a “fairly healthy buffer” of medications, so there’s no immediate concern. In mid-2025, the White House ordered the Department of Health and Human Services to build a six-month stockpile of 26 essential medicines.

The International Federation of Pharmaceutical Manufacturers and Associations, which represents global drugmakers, told Healthcare Brew the group is closely monitoring the war in Iran and working to ensure an uninterrupted drug supply.

Beyond shortages. Rather than a lack of supply, Warrick said he’s concerned drug prices will increase as a result of the war.

Roughly 35% of pharmaceuticals are shipped via air cargo, and with fuel prices increasing and flights in the Middle East that would be transporting medicines being canceled, cost increases are “nearly guarantee[d],” he said.

“What that’s done is it’s reduced the amount of available space to move air freight around the world,” he added. “When there’s any sort of scarcity, that automatically will drive up price.”

Consumers will likely be affected by price increases for common drugs like aspirin as well as for some cancer treatments in the short term, as the supply chain has already seen an increase in shipping costs, Warrick said.

But “it’s not a blanket statement that everything’s going to increase in price and everything’s going to become scarce,” he added.

Another concern is generic manufacturers will stop making some medicines due to financial strain, according to Laura Bray, founder and chief change maker at Angels for Change, a nonprofit specializing in solving drug shortages.

Twice as many generics go into shortage as branded drugs, according to a 2025 analysis from the Office of the Assistant Secretary for Planning and Evaluation. Many generics are cheap to manufacture and travel from India to the US via the Strait of Hormuz. Generic drugmakers typically operate on thin margins, so any cost increases could lead companies to discontinue medications that may no longer be economically feasible to produce.

“The war could be a force majeure reason to get out of contracts and leave the marketplace for something that already isn’t really viable,” Bray said.

In preparation. While it may seem logical for hospitals and providers to stock up on essential medications to get ahead of potential shortages, that could actually make the matter worse, Bray said.

That’s because hospitals buying up extra medicines they may not need would stretch supplies even thinner. Warrick compared it to the empty shelves seen during the early days of the Covid-19 pandemic, when consumers bought supplies like toilet paper and aspirin in bulk.

“What could cause challenges is people buying differently than they did for fear of those changes, and that could be immediate and severe,” Bray said. Instead, she advised health systems to call their supplier and manufacturer partners and ask if they have resiliency programs or buffer supplies of vulnerable medicines.

Warrick agreed surveillance is the best strategy for health systems for now rather than stockpiling.

“It is useful to just monitor how that supply is changing, or if you’re seeing longer lead times, or if you’re seeing more challenges in ordering—then plan accordingly,” he said.