Strait of Hormuz: How Some UK Medication Could be Cut Off

As the conflict continues in the Middle East and the Strait of Hormuz remains closed, there is growing concern about how the UK can source key medical supplies.

There has been some concern throughout the year, particularly around sourcing aspirin in the UK, as the BBC reported back in January that the cost of the drug has skyrocketed by 1,000% as a nationwide shortage grips the UK, according to reports from frontline pharmacists.

The supply chain crisis has seen some wholesalers hike prices to staggering levels, as one pharmacist reported being charged £7.82 for a single box of aspirin, a medication that typically costs just 38p.

Impact on local dispensaries and patients

The shortage is widespread, affecting the vast majority of local dispensaries. A National Pharmacy Association (NPA) survey revealed that 86% of pharmacies are currently unable to fulfil aspirin requests, with limited stocks being strictly reserved for patients with acute medical conditions or those holding emergency prescriptions.

Aspirin is a versatile non-steroidal anti-inflammatory drug (NSAID) used for short-term pain relief, fever reduction and reducing inflammation. It also acts as an antiplatelet agent, with low doses used long-term to prevent blood clots, heart attacks and strokes, particularly in high-risk individuals.

The Department of Health and Social Care (DHSC) has acknowledged the strain but remains optimistic, stating they have "robust measures in place" to minimise the impact on patient care and manage the ongoing disruption.

Geopolitical instability and logistics pressure

Now, this is continuing, with the fear being more widespread to off-patent medicines. As reported by Pharmacy Business, Mark Samuels, Chief Executive Officer at Medicines UK, which represents manufacturers of the cheap, off-patent drugs known as generics that make up 85% of medications used by the NHS, 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.”

Quoted in The Guardian, David Weeks, Director of supply chain risk management at the analytics group, Moody’s, said: “It’s the perfect storm. We have the conflict in the Gulf that caused the strait of Hormuz to shut down, and India is known as the pharmacy of the world. They produce a lot of the generic [off-patent] drugs and APIs [active pharmaceutical ingredients]. With the geopolitical situation, it’s harder and harder to get those out.”

British supply chains felt the strain during the Covid-19 pandemic as paracetamol and other essential painkillers became scarce. This shortage was largely driven by production bottlenecks in India, a global pharmaceutical powerhouse that supplies 60% of the world's generic drugs and half of the US market. Currently, the UK produces only about 25% of its medicines domestically, leaving it heavily reliant on these international manufacturers.

A Department for Health and Social Care spokesperson said to the BBC: "The vast majority of the UK's licensed medicines are in good supply and aspirin stock remains available to pharmacies from wholesalers.

"To make sure this remains the case, we work with suppliers to resolve any issues and we are investing more in the domestic medicine manufacturing industry."