Soaring medicine prices, shortages, and failures in insurance coverage are forcing Iranian families to delay treatment or abandon it altogether.
For millions of Iranians, getting sick has become a financial crisis.
The cost of a medical consultation, laboratory tests, and prescription drugs can now consume a substantial share of a low-income household’s monthly earnings. As medicine prices continue to rise and shortages affect pharmacies across the country, many patients are delaying medical visits, reducing their medication intake, searching for cheaper alternatives, or resorting to self-treatment.
For people with chronic, serious, or specialized illnesses, the consequences can be far more dangerous.
Recent accounts from residents of Tehran and other cities illustrate how rapidly healthcare costs have escalated. A simple case of flu or a respiratory infection can reportedly cost around 2 million tomans once the doctor’s consultation and prescription are included. For households already struggling with rent, food, utilities, and other basic expenses, even such an apparently minor illness can become unaffordable.
One woman in southern Tehran recently reported paying 750,000 tomans for a general-practitioner consultation. The medicines prescribed for her cold—including ibuprofen, codeine, acetaminophen, and amoxicillin—cost another 540,000 to 810,000 tomans depending on the quantities purchased. Her total bill therefore exceeded 2 million tomans.
And these figures come from a relatively less expensive part of Tehran. Residents say prices can be significantly higher in central and northern districts, while the lack of effective oversight has produced considerable differences between doctors and medical centers.
Medicine Prices Changing by the Week
The problem is not simply that medicines are expensive. Patients also describe a market in which prices can change dramatically within days.
A Tehran resident recently reported purchasing a packet of the painkiller Novafen for 90,000 tomans, only to return less than a week later and find the same medicine priced at 170,000 tomans.
Other commonly used medicines and supplements are also consuming increasing amounts of household income. Residents have reported paying 150,000 tomans for a package of Cilax and 270,000 tomans for a 20-tablet zinc supplement, with some formulations costing considerably more.
Imported medicines present an additional problem. Patients searching for imported eye drops, for example, may have to visit several pharmacies before finding them, and the price can reach approximately 1.3 million tomans.
For families with children, even basic nutritional supplements are becoming a burden. One parent reported paying around 200,000 tomans for vitamin drops for a two-year-old child. Iron drops that were previously distributed free through health centers are reportedly no longer consistently available without charge, forcing families to purchase them from pharmacies for roughly 500,000 tomans.
Imported versions, when available at all, are often several times more expensive.
Chronic Illness Turns Healthcare Into a Monthly Struggle
The financial burden becomes particularly severe for elderly people and patients who cannot interrupt their treatment.
A 67-year-old woman suffering from diabetes and hypertension said she pays approximately 230,000 tomans for each strip of her diabetes medication and 85,000 tomans for each strip of her blood-pressure medication. Based on her daily dosage, those two medicines alone cost her around 2.58 million tomans per month.
That figure excludes doctors’ visits, laboratory tests, and any other medication she may require. She has no fixed source of income or pension sufficient to cover these costs.
Other patients face a second obstacle: medicines may be technically available in the market but practically impossible to find.
One patient who requires continuous medication for neurological and gastrointestinal problems said that a single purchase of three medicines—including Aspirin and Asentra—cost at least 555,000 tomans. More seriously, Asentra has repeatedly become difficult to obtain. At one point, the patient was unable to find it at all, resulting in an involuntary interruption of treatment and a deterioration in both physical and psychological well-being.
For patients who depend on regular medication, a shortage is not merely an inconvenience. A missing prescription can mean an untreated condition, a medical emergency, or a serious deterioration in health.
The same problem has been reported by families caring for elderly patients with respiratory illnesses. In one case, the family of an elderly man reportedly visited more than ten pharmacies in search of a prescribed inhaler. The patient was struggling to breathe throughout the search. The family eventually found the medicine for approximately 1.8 million tomans.
Insurance Is Failing to Shield Patients
Iran’s healthcare crisis is compounded by weaknesses in the insurance system.
Being covered by Social Security insurance does not necessarily mean that a patient can obtain affordable medication. Reports indicate that accumulated debts and disruptions in reimbursement have caused pharmacies and healthcare providers to face problems with insurance coverage and payment systems.
Ali-Akbar Ayvazi, secretary of the Tehran Social Security Retirees’ Association, told the Iranian newspaper Ham-Mihan that he had repeatedly witnessed problems at major pharmacies in Tehran. According to his account, insurance-system connections can reportedly be disrupted late at night, after which medicines are charged at their full price.
Ayvazi also said that medicines previously reported as unavailable sometimes appear during these periods at unrestricted prices. For patients with specialized illnesses, he said, the cost of a monthly medicine basket can reach between 80 million and 120 million tomans.
For wealthier families, such expenses may be devastating but manageable. For many retirees and low-income households, they effectively place continued treatment beyond reach.
A Supply Crisis Behind the Pharmacy Counter
The mounting burden on patients is occurring alongside a broader crisis in Iran’s pharmaceutical supply chain.
Pharmacies and pharmaceutical companies have been struggling with liquidity problems, while reports indicate shortages affecting hundreds of medicines. On September 9, Shahram Kalantari, head of the Iranian Pharmacists Association, estimated that approximately 400 medicines were in short supply nationwide.
Food and Drug Organization chief Mehdi Pir-Salehi has disputed reports portraying the medicine situation as a widespread crisis, calling some published statistics inaccurate.
Yet patients encounter a different reality when they enter pharmacies: higher prices, unavailable prescriptions, repeated searches for essential medicines, and increasing out-of-pocket expenses.
The result is a healthcare system in which the consequences of economic mismanagement are increasingly transferred from institutions to patients.
When Patients Stop Seeking Treatment
The most serious consequence of the medicine crisis cannot be measured simply in tomans.
When a family cannot afford a doctor’s visit, it may postpone diagnosis. When a prescription is too expensive, a patient may take fewer doses. When a medicine is unavailable, treatment may be interrupted. And when insurance fails to cover the expected cost, even patients who technically have healthcare coverage may be forced to pay out of pocket.
For cancer patients, people with rare diseases, elderly patients with chronic conditions, and others who depend on uninterrupted treatment, these decisions can carry life-threatening consequences.
Iran’s medicine crisis is therefore not simply a problem of inflation or pharmacy shortages. It is becoming a barrier to healthcare itself.
As the cost of food, housing, and other necessities continues to erode household purchasing power, medicine is increasingly competing with basic survival expenses. For a growing number of Iranians, the question is no longer whether they need treatment, but whether they can afford to receive it.
That is the deeper measure of the crisis: a healthcare system in which the price of staying alive is increasingly being transferred to patients and their families.