How Conflict Reveals Pharma Supply Chain Vulnerabilities

The ongoing closure of the Strait of Hormuz is placing unprecedented pressure on pharmaceutical supply chains serving the UK, with the NHS confronting mounting logistics costs and delivery delays for critical generic medications that account for the majority of prescriptions.

The disruption comes as the conflict in the Middle East continues, highlighting the fragility of global medicine supply routes and the UK's heavy dependence on international manufacturing hubs.

The situation has intensified concerns about the resilience of pharmaceutical supply chains, particularly for off-patent drugs that flow through now-constrained shipping lanes.

Supply chain pressures began manifesting in December 2025 with aspirin shortages across the UK.

In January 2026, the BBC reported that supply chain disruptions had driven the cost of the drug up by 1,000%, according to frontline pharmacists. Some wholesalers reportedly charged £7.82 for a single box of aspirin, compared to the typical price of 38p, as logistics bottlenecks cascaded through the distribution network.

Pharmaceutical distribution networks under strain

The impact on pharmaceutical distribution has been severe and widespread.

According to a National Pharmacy Association (NPA) survey, 86% of pharmacies could not fulfil aspirin requests, with limited stocks being reserved strictly for patients with acute medical conditions or emergency prescriptions.

The Department of Health and Social Care (DHSC) acknowledged the supply chain strain but stated they have "robust measures in place" to minimise the impact on patient care and manage the ongoing disruption.

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Generic medicine supply routes disrupted

The supply chain crisis has now extended beyond aspirin to threaten the broader category of off-patent medicines.

Mark Samuels, Chief Executive Officer at Medicines UK, which represents manufacturers of generic drugs that comprise 85% of NHS medications, explained the logistics challenges facing the sector.

"The escalating conflict in Iran, and the wider instability across the Middle East, poses a significant risk to future UK medicine supplies," Mark says, as reported by Pharmacy Business.

"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."

Mark noted that medicine production requires long-term planning and current uncertainty makes it increasingly difficult for manufacturers to operate with confidence.

He emphasised that off-patent medicines, which account for 85% of NHS prescriptions, operate on high efficiency and razor thin margins, meaning any prolonged crisis driving up operating costs will disproportionately affect these manufacturers and could risk supply shortages or increased costs for the NHS.

Global pharmaceutical supply chain dependencies

David Weeks, Director of Supply Chain Risk Management at the analytics group Moody's, characterised the situation as a convergence of multiple supply chain stressors, according to The Guardian.

"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."

The UK's pharmaceutical supply chains experienced similar strain during the COVID-19 pandemic when paracetamol and other essential painkillers became scarce.

That shortage was largely driven by production bottlenecks in India, which supplies 60% of the world's generic drugs and half of the US market.

The UK currently produces only about 25% of its medicines domestically, leaving pharmaceutical supply chains heavily reliant on international manufacturers and vulnerable to shipping route disruptions.

A Department for Health and Social Care spokesperson tells the BBC that the vast majority of the UK's licensed medicines remain in good supply and aspirin stock remains available to pharmacies from wholesalers.

The department stated it works with suppliers to resolve supply chain issues and is investing more in domestic medicine manufacturing capacity.