Iran’s official medicine market is being hollowed out as policy instability, currency disruptions and shortages push more patients toward illegal sellers, counterfeit drugs and informal supply networks, industry figures and officials have warned.
The warnings point to a new phase in Iran’s long-running drug crisis. The problem is no longer only that medicines are expensive or hard to find. The formal supply chain itself is weakening, while the black market grows around patients who cannot obtain medicine through pharmacies.
Haleh Hamedifar, head of the Association of Medical Biotechnology Product Manufacturers, told the semi-official ISNA news agency that the main challenge facing Iran’s pharmaceutical industry is not simply a shortage of foreign currency, but “instability in decision-making and lack of coordination in implementation.”
“The pharmaceutical industry cannot be managed with daily decisions, changing circulars and unpredictable processes,” she said.
Hamedifar warned that sudden policy changes disrupt the supply of raw materials, production and distribution, with effects that appear months later “in pharmacies, hospitals and ultimately at the patient’s bedside.”
Iran says it produces most of the medicines consumed in the country, but domestic production still depends on imported raw materials, equipment, packaging, machinery and spare parts. That leaves even locally made drugs exposed to banking restrictions, currency decisions and import delays.
Hamedifar said recent shifts in currency rules have forced some raw materials out of preferential currency categories and into exchange-rate systems that are not reliably funded. Alternative routes, including the use of export proceeds or privately held foreign currency, were introduced before the administrative infrastructure was ready, she said.
Companies have been forced to amend files, repeat import registrations and restart procedures they had already completed, she said.
“The problem in many cases is not the decision itself, but how it is implemented,” Hamedifar said.
She said outages and errors in government platforms, including disconnects between trade, drug-regulation and banking systems, should not be treated as technical glitches because each delay can postpone the arrival of raw materials and later disrupt drug supply.
Interior Ministry spokesman Ali Zeynivand separately acknowledged that high medicine prices are real and said the government does not deny that internal failures may be part of the problem.
“Part of the problems are caused by the imposed war, another part by the sanctions that already existed, and part may be due to our shortcomings or lack of precision,” he told the Dideban Iran news website. “We do not reject any of these.”
Zeynivand said President Masoud Pezeshkian, himself a physician, is personally sensitive to the issue and that the Health Ministry, Plan and Budget Organization and Central Bank are working on measures to contain the situation. But he cautioned that Iran’s economic problems would not be solved simply by signing a memorandum.
For patients, the consequences are already visible in higher out-of-pocket costs, incomplete prescriptions, empty pharmacy shelves and growing reliance on unofficial sellers.
Mehdi Sanei, an investigator at Iran’s medical crimes prosecutor’s office, told the Iranian daily Shargh that Iran has only one legal medicine market: the official network supervised by the Health Ministry and Food and Drug Administration. Any medicine sold outside that chain is illegal, he said.
“In the field of medicine, there is no such thing as a legal free market,” Sanei said.
He said shortages are the starting point for much of the illegal trade. When patients cannot find medicine in pharmacies, they turn to dealers, Telegram channels, middlemen and informal networks.
“As long as medicine shortages exist, the smuggling market will exist,” he said.
Sanei warned that the illegal drug market is unusually profitable because patients cannot postpone treatment. Families dealing with cancer or chronic illness may sell savings, jewelry, cars or even homes to obtain scarce medicine.
“I do not know of a commodity whose profit is as guaranteed as smuggled medicine,” he said.
He said some black-market medicines are official Iranian-made drugs diverted from the legal system through fake prescriptions, distribution violations or other routes. But he described an even more dangerous trend: the growing presence of counterfeit or unauthorized medicines made inside Iran.
Sanei estimated that more than 80 percent of medicines in the illegal market are now unauthorized domestic products rather than genuine imported drugs.
Those products may be made in illegal workshops with unknown or ineffective materials and fake packaging, he said. Some may contain no active ingredient, contamination or harmful substances.
“People pay heavy costs, and there is no guarantee that what they receive is really medicine,” he said.
The result is a self-reinforcing cycle: shortages weaken the legal market, patients move toward illegal sellers, the black market becomes more profitable, and the official system loses more ground.
“The smaller the legal market becomes, the larger the illegal market becomes,” Sanei said.
Parisa Valentina Pouyan, director of the Pouya Helpers of Child Workers Institute, told Iran’s labor-focused ILNA news agency that baby-selling is a hidden and complex phenomenon driven not only by poverty but also by addiction, cultural pressures, weak oversight, lack of parenting education and failures in state protection systems.
“Buying and selling children is one of the most horrifying forms of social harm and one of the most damaging acts committed against children,” Pouyan said.
Her remarks followed renewed attention in Iranian media to the case of a mother accused of selling several of her newborns over different years for small sums, reviving concerns about underground markets for infants and the future awaiting children transferred outside legal adoption channels.
A recent analytical report by Iran’s State Welfare Organization, known as Behzisti, found that illegal adoption remains a serious challenge for the country’s child-protection and judicial systems.
According to the report, 18,240 adoption cases were registered from 2013 to 2024, of which 13,020, or 71 percent, were legal, while 5,224, or 29 percent, were recorded as illegal.
Behzisti is the main state body responsible for welfare and child-protection cases in Iran, including formal adoption procedures. Illegal adoptions take place outside that system, often through private arrangements, brokers or concealed transfers of newborns.
Pouyan said official and precise statistics on baby-selling do not exist because the practice is hidden. But she said poverty creates fertile ground for such cases, especially during wider social and economic crises.
Still, she warned against reducing the issue to poverty alone.
“Would every poor family sell its child?” she said. “If parents have sold a child once and their living conditions improve a little, does that mean they will never do it again?”
Pouyan said global experience shows baby-selling has become a lucrative trade in some places, and that poverty is only one driver. She cited addiction, sex work, cultural pressures and the possibility that a mother herself may have been a victim of child-selling as factors that can feed the trade.
She said the hidden nature of illegal transfers means the child’s future is often irrelevant to the transaction.
“In this kind of trade, parents who sell their baby or child do not care whether the buyers have the conditions and qualifications needed to become parents,” she said, adding that in illegal transfers “money comes first.”
Pouyan said she had personally been approached several years ago by someone seeking a child for a couple living abroad, both doctors, who wanted to adopt by finding a parent willing to sell a child. She said she rejected the request and warned she would report any such case.
According to Pouyan, the darker danger is that not all buyers are seeking parenthood.
In some cases, she said, children are bought or taken through illegal adoption channels for domestic labor or other forms of exploitation.
“I have seen a case in which a child was illegally adopted and, a few years later, became the family’s servant,” she said.
Pouyan said Iran’s response to baby-selling and illegal adoption is weakened by poor oversight, ineffective intervention by responsible agencies and possible misconduct inside institutions meant to protect children.
