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Iran’s drug squeeze hits transplant care as key anti-rejection pill runs out

Dec 1, 2025, 11:34 GMT+0
A patient lies on a bed at Masih Daneshvari Hospital in Tehran on December 1, 2025, as unhealthy air pollution strains vulnerable groups
A patient lies on a bed at Masih Daneshvari Hospital in Tehran on December 1, 2025, as unhealthy air pollution strains vulnerable groups

Iran is facing a fresh shortage of the brand-name anti-rejection drug Myfortic with pharmacies halting distribution in several cities and clinicians warning that forced switches to substitutes could endanger a minority of kidney-transplant patients.

Patients in Mashhad said rations shrank from two months to one week before stocks of the drug (mycophenolic acid 360 mg) “fell to zero,” with pharmacists advising a move to domestically made equivalents, the ILNA news agency reported.

Fatemeh Pour-Rezagholi, secretary of Iran’s Kidney Transplant Scientific Association, said originator-brand supplies have not been distributed recently, citing foreign-exchange constraints, sanctions-related frictions and customs delays.

She added that Iranian versions are available and effective for most patients, but unplanned brand changes can be stressful or risky for those early post-transplant or with prior rejection. Importers have indicated the original brand may return later in winter, according to ILNA.

Doctors and pharmacists told ILNA that 70-80% of recipients tolerate domestic formulations, but roughly 10-20% may require a specific brand or closer therapeutic-drug monitoring.

Patient groups and clinicians are urging clearer import timetables, steadier FX allocation for critical transplant drugs and contingency guidance to minimize unplanned switches.

Clinicians say the fiscal and human costs are far higher if grafts fail and patients return to dialysis, and have asked regulators to protect a baseline of imports for high-risk cases while stabilizing domestic supply for the majority.

US sanctions policy formally exempts most medicines and many medical devices, with humanitarian channels – such as Switzerland’s state-backed payment mechanism – designed to process vetted transactions.

In practice, suppliers and aid groups say persistent “over-compliance” by global banks, shippers and insurers fearful of sanctions risk, which can delay or block payments, shipments and insurance even for lawful medical goods.

Economists also point to the rial’s volatility and domestic pricing and procurement rules as recurring hurdles that raise import costs and complicate supply planning.

According to Mehr News on Monday, Iran has raised medicine prices several times in recent months under a “realistic pricing” policy meant to support the domestic pharmaceutical industry, but insurance coverage has not kept pace – leaving patients to shoulder a growing share of drug costs as reimbursements lag behind the hikes.

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