Britain could face a UK medicine shortage risk in just a few weeks if the war in Iran continues, experts warn. Essential drugs, from painkillers to cancer treatments, may become scarce, while prices for some medicines are expected to rise. The conflict has disrupted global supplies of critical raw materials, including oil, gas, crop fertiliser, and helium. Pharmaceutical supplies are now also under pressure. David Weeks, director of supply chain risk management at Moody’s in Texas, said the situation is a “perfect storm.” He explained that India, often called the pharmacy of the world, produces a large share of generic drugs and active pharmaceutical ingredients (APIs). “With the geopolitical situation, it’s harder and harder to get those out,” he added. Air transport has been affected by the partial closure of airports in Dubai, Doha, and Abu Dhabi, forcing drug companies to reroute shipments. Some shipments are now going by sea, increasing delivery times. Shipping, the main route for most medicines, is also strained due to the near-total closure of the Strait of Hormuz. Mark Samuels, chief executive of Medicines UK, said the country is not in crisis yet but warned that shortages could appear in a matter of weeks. Most medical distributors keep six to eight weeks of stock, and hospitals in England are required to hold eight weeks of medicine supplies. During the Covid pandemic, paracetamol and other common drugs were in short supply as Indian manufacturers struggled to meet demand. The UK produces about a quarter of its medicines domestically, with around a third coming from India and another portion from the EU. The ongoing war has already doubled air freight costs. “One in five NHS medicines comes in by air, and currently manufacturers are trying to absorb those costs,” said Samuels. “They have historically low margins, so some drugs could become loss-making to supply to the NHS.” Suppliers have long-term pricing agreements with NHS hospitals but can adjust prices for GP practices and pharmacies, meaning patients could see higher costs. Expensive treatments, including cancer drugs, infectious disease therapies, biologics, and cell and gene therapies, rely on rapid air transport. Wouter Dewulf, professor at the Antwerp Management School and pharma logistics expert, said medicine supplies are currently “not disrupted, but disturbed.” He expects modest price increases if the conflict continues. “Everything depends on how long the war lasts,” he said. Frank Van Gelder, healthcare and pharma supply chain strategist and secretary general of Pharma.Aero, said airspace disruptions in the Middle East have hit the industry hard. Before the war, roughly 3,700 passenger flights carrying cargo passed through the region daily. Air cargo levels dropped 80% earlier this month and remain low. Sea transport is an alternative for stable generic drugs but adds two weeks to delivery times and nearly $1 million in fuel costs per ship. Rising oil and gas prices also increase the cost of petrochemical products such as methanol and ethylene, which are crucial for producing APIs, as well as syringes, vials, tubing, gowns, and protective gear. Van Gelder warned that these costs will ultimately be passed on to patients or public health systems. “In the end we all pay more, right?” he said, emphasizing the broad economic impact of supply chain disruptions on the life sciences and pharmaceutical industry. Experts stress that the UK must act quickly to prevent shortages. With hospitals and pharmacies depending on imported medicines, any prolonged disruption could create a serious public health risk.