By James Davies
Every front page is filled with the conflict in the Middle East. It is hard to ignore, especially if filling your car up at the pump.
Much has been made in the headlines of medicine shortages, but the complexity of the medicine supply chain means the impacts on us will be subtle and felt over time. Several major media outlets have conflated some of the current medicine shortages with the conflict in Iran, but many of these persisted before the conflict.
Thankfully, the UK has minimal reliance on medicines manufactured in the conflict region. While Iran is a major pharmaceutical producer, most are used domestically or in nearby Middle Eastern countries, so the UK is not dependent on Iranian manufacturing. Imminent medicine shortages are therefore unlikely.
There is logistics disruption between India, Europe, and the UK, although products are still largely reaching the UK. Most sea freight has already diverted away from the Red Sea. Air freight (mainly cold‑chain, short‑shelf‑life products like vaccines and biologics) is facing delays due to impacted transit hubs, with flights being rerouted, driving up cost.
The broader situation is still uncertain, and Community Pharmacy England is monitoring potential long‑term effects on energy and raw materials. Costs for key pharmaceutical inputs have risen sharply due to currency shifts (particularly a stronger dollar against the rupee) along with higher petroleum‑linked expenses and fluctuating global shipping costs
Rising costs are stopping some raw‑material traders from accepting orders. Solvent prices have increased, and many API prices have more than doubled. Petroleum‑based plastics, such as those used for IV bags and vial stoppers, are also being affected
Indian manufacturers are reporting major shortages of propane and LPG due to the closure of the Strait of Hormuz, forcing some pharmaceutical plants to scale back or shut down. Key manufacturing hubs are facing acute shortages and have asked the Government for help. Countries are using strategic reserves, but a prolonged conflict would further disrupt production.
Indeed, we’re already seeing these rising costs reflected at the petrol pump, a pressure that wholesalers and medicines distributors feel especially strongly, and could play out in fuel surcharges.
Rising input costs and supply pressures are likely to affect frontline pharmacy teams in the coming months. As these challenges move through the supply chain, overall costs will rise, pushing up medicine prices. Generic prices in England are already at historic lows, with 13 of the top 20 primary‑care medicines costing under £1 per pack. This leaves manufacturers with little room to absorb further increases.
In England, NHS pharmacies must supply prescriptions with reasonable promptness but are reimbursed only at the Drug Tariff price. As market prices rise, it’s vital that pharmacy teams report difficulties obtaining medicines at these prices, enabling Community Pharmacy England to seek price concessions from the Department of Health and Social Care. You can report products directly over Drug Tariff price to us here.
In February, unusually sharp price rises for UK generics led the DHSC to issue its highest number of price concessions in nearly three years. Community Pharmacy England continues to push for these concessions but relies on pharmacies submitting pricing data to do so.
The duration of the conflict will shape the long‑term impact on prices, but what’s clear is that these rising costs must be absorbed somewhere in the system. Community Pharmacy England is committed to ensuring they do not fall on the shoulders of already stretched community pharmacies.
(James Davies is the Director of Research and Insights, Community Pharmacy England)
