Iran – Medicine shortages in Iran fuel the black market

Growing medicine shortages in Iran are pushing patients toward the black market, where essential drugs can be found at prices several times higher than the official ones.

The Iranian Pharmacists Association says around 800 medicines are currently on the list of essential drugs missing in the country. The shortages have been worsened by financial constraints, difficulties in importing medicines and raw materials, and flight restrictions following the 12-day war with Israel in June 2025 and the ongoing conflict with the United States.

Mehdi Pirsalehi, head of Iran’s Food and Drug Administration, has cited financial difficulties, such as the lack of foreign currency needed for imports, as one of the main causes of the crisis.

For patients, the consequences can be severe.

A 45-year-old woman being treated for breast cancer told Radio Farda of Radio Free Europe/Radio Liberty that pharmacies had repeatedly told her they did not have in stock the Iranian version of Aromasin, a drug she must take every day.

A box of 30 tablets officially costs 4 million rials (around 2 euros). She paid 50 million rials (around 26 euros) on the black market, 12.5 times more than the official price.

She also said she paid at least 30 million rials (around 15 euros) for each injection of Zometa and that two of them turned out to be counterfeit and caused her complications. Like the other people who spoke to RFE/RL’s Radio Farda, she asked that her name not be made public for security reasons.

A 39-year-old man being treated for lung cancer said he now spends 750 million rials (around 386 euros) a month on Sandostatin LAR, which he obtains through pharmacies run by the Iranian Red Crescent Society. Last year, he spent 220 million rials (around 113 euros), an increase of 241 percent.

According to the Statistical Center of Iran, the average monthly salary in Iran is around 350-450 euros, while salaries in cities such as Tehran are considered to be around twice that level.

Radio Farda is banned from operating in Iran and, for this reason, the accounts in this report cannot be independently verified.

Sales via Telegram

While pharmacies in Iran face supply shortages, Radio Farda found sellers advertising medicines through Telegram groups and other online channels. They offered medicines for Parkinson’s disease, asthma, depression, diabetes and heart disease.

One seller offered RhoGAM, an injection given to Rh-negative women during pregnancy or after a miscarriage to prevent complications. The same seller also had Symbicort, which is prescribed for asthma and chronic obstructive pulmonary disease, as well as nortriptyline, which is used for depression and migraines.

Some sellers said that flight restrictions imposed because of the war had made it harder to import medicines, but that alternative routes remained open. One importer asked buyers to first confirm availability and then offered a long list of medicines for delivery by mail.

Another seller, a woman, said she worked with her brother, who sources the medicines “from wherever he can”, while she handles marketing and sales.

“You just place the order,” she said. “Selling medicines is not profitable at all. We sell medicines only so that we can survive.”

Medicines have no fixed prices

Black market prices vary widely and often significantly exceed pharmacy prices.

A seller in Isfahan offered Madopar, a Parkinson’s drug, for 20 million rials (around 10 euros). At almost the same time, a seller in Yazd asked for 72 million rials (around 37 euros), more than three times as much. Estradiol valerate, an estrogen drug, was offered for 40 million rials (around 21 euros), compared to 6 million rials (around 3 euros) in pharmacies.

Even official prices are rising. A spokesperson for the Iranian Pharmacists Association recently told Iranian media that medicine prices had risen by an average of 30 to 70 percent this year. Some foreign-brand medicines had become up to 300 percent more expensive.

For patients who manage to find their medicines, the question is increasingly whether they can afford them. For sellers, as the woman who works with her brother put it, this activity is about survival, RFE/RL reports.