Key Summary
- Conflict disrupting routes delays risk for vital medicines, especially cancer treatments.
- Rising costs and the trouble of accessing petroleum-based ingredients add pressure on drug production and supply.
- UK reassures stability for now, but warns shortages could worsen if the crisis continues.
The ongoing war in the Middle East is disrupting the flow of critical medicines, imperilling supply routes for cancer drugs and other treatments that require refrigeration and forcing companies to reroute flights and find overland access into the region.
In addition, many common drugs, including aspirin, paracetamol, ibuprofen and a range of antibiotics, rely on petroleum-based ingredients as well as other components sourced from the Middle East.
The delays in delivery of oncology medicines can have dire consequences for patients, who might be forced to restart a course of therapy, or see their cancer worsen.
With the war in its third week, various pharmaceutical organisations in the UK have raised concern regarding the medicine supplies and availability of essential medicines to patients, and fear that the challenges would increase if the war prolongs.
Medicines UK chief executive Mark Samuels said, “The escalating conflict in Iran, and the wider instability across the Middle East, poses a significant risk to future UK medicine supplies.
“While we are not currently seeing exceptional shortages, manufacturers are facing sharp increases in transportation costs, particularly for air freight. Shipping - the primary route for most medicines - is also under strain due to the effective closure of the Strait of Hormuz, creating knock-on pressures across global supply chains.
“Medicine production requires long-term planning, and the current uncertainty makes it increasingly difficult for manufacturers to operate with confidence.
“Off-patent medicines, which account for 85 percent of NHS prescriptions, run on high efficiency and razor thin margins. Any prolonged crisis that drives up operating costs will disproportionately affect these manufacturers and risks leading to supply shortages or increased costs for the NHS.”
The Company Chemists Association chief executive Malcolm Harrison said, “The conflict in the Middle East, and the impact it is having on energy costs and the use of established trade routes, has the potential to affect all global supply chains. However, we are not aware of any impact that the conflict is currently having on community pharmacies obtaining medicines for patients.
The supply chain remains resilient and is currently able to cope with ongoing pressures. The CCA and its members will of course continue to work closely with our colleagues across the supply chain, and in government, to ensure patients can access the medicines they need, when they need them.
The CCA has also recently established the Medicines Supply Resilience Group (MSRG), bringing together representatives from across the supply chain alongside officials from the Department, NHS and MHRA, to identify practical steps to improve the system’s long-term sustainability and protect patient access.”
In a letter to health secretary Wes Streeting, Independent Pharmacies Association (IPA) chief executive officer Leyla Hannbeck said the war could worsen an already difficult situation for community pharmacies and patients would suffer.
She said: “Community pharmacies are already feeling the strain of fragile global supply chains. Tensions around the Strait of Hormuz, one of the world’s most important shipping routes, have raised fears of rising crude oil prices and disruptions to international trade. This matters for medicine."
Dr Hannbeck said: “Many common drugs, including aspirin, paracetamol, ibuprofen and a range of antibiotics, rely on petroleum-based ingredients as well as other raw materials sourced from the Middle East and beyond.
“Any disruption to these supplies increases production costs and slows manufacturing, which quickly translates into lower availability on pharmacy shelves.”
She pointed out that the UK is already facing a shortage of painkillers such as co-codamol and opioids used for managing chronic pain.
The UK is under the threat of medicine shortage, with a government’s list of 150 insufficient medicines expanding from painkillers like co-codamol, opioids, cancer medicines like Efudix, antidepressants, hormone replacement therapies, etc. with a wide variety of them imported from nations like China and India.
The war sparked by the US and Israeli attack has now blocked key air transit hubs as well as the shipping routes.
The IPA has urged the government to restock these medicines at the earliest and is asking the ministers to appoint a medicines shortage tsar to create a “critical medicines list” to resolve the shortage crisis.
The Department of Health and Social Care (DHSC) spokesperson has responded, assuring better financial support for domestic manufacturing of medicines, along with the government’s engagement with other countries to improve supplies.
NPA director of corporate affairs Gareth Jones said, “We are not currently seeing widespread disruption to UK medicines supplies caused specifically by the situation in the Middle East.
“The Department of Health has promised to monitor developments, as will we, while keeping our members informed.
“While there is no immediate cause for alarm, a prolonged crisis could worsen the frailty of supply chains, due to the UK’s reliance on international manufacturing and transport routes."
“In anticipation of such a scenario, it would be sensible of the government to take practical steps, including giving pharmacists greater flexibility to substitute medicines where appropriate, to maintain continuity of care for patients.”
