Iran war drives up cost of paracetamol and hay fever drugs by up to 30% in England

Pharmacies warn of supply constraints as freight costs double and petrochemical inputs tighten

The war in Iran has pushed up the retail price of widely used over-the-counter medicines in England by as much as 30 per cent, with pharmacists warning that further increases are likely unless key supply routes reopen.

Community chemists are charging customers 20 to 30 per cent more for paracetamol than they were in February, according to the National Pharmacy Association, which represents 6,000 pharmacies in England. Many outlets have run out of certain strengths of aspirin and co-codamol. Prices for cetirizine tablets, a common hay fever treatment, have risen by a similar margin over the same period.

The conflict, now in its eighth week, has driven up petrol and diesel prices, inflating manufacturing and transport costs that have fed through the supply chain. Pharmacies are now paying 40 to 50 per cent more to order stock from wholesalers. Air freight costs have doubled — a significant pressure given that one in five NHS medicines arrives by air. The war has also disrupted supplies of petroleum derivatives from the Gulf region, which are used in the production of paracetamol, aspirin and co-codamol.

Olivier Picard, chair of the NPA, said his Berkshire pharmacy had been unable to order paracetamol on 27 March. When stock became available again days later, the wholesale price had doubled. He said the price he pays for a pack of 100 500mg tablets had risen from 41p to £1.99 by the end of March, before easing to £1.09. That has filtered through to patients: a pack of 32 paracetamol that cost £1.19 before the conflict now retails at £1.50.

For cetirizine, his purchase price has nearly doubled since January, from 19p for a pack of 30 tablets to 37p, with some distributors charging as much as £3. Allergy sufferers face the prospect of further increases by May or June, when the main hay fever season peaks. Mr Picard advised against panic buying, warning that stockpiling would exacerbate shortages and accelerate price rises.

The pressures are also hitting the NHS medicines budget. Manufacturers of generic off-patent drugs, operating on thin margins, have begun raising prices, inflating both the health service's direct procurement costs and its pharmacy reimbursement bill. In March, a record 230 drug items were placed on the government's price concessions list — compared with 90 in the same month last year — allowing pharmacies to be reimbursed at higher rates. The list included blood pressure medications, anxiety drugs, antidepressants and painkillers such as codeine and co-codamol.

Paracetamol, however, was not among them, despite being one of England's most-prescribed medicines, with 1.3mn packs dispensed every month. The government reimburses community pharmacies just 49p for a prescribed 32-pack — a rate that Mr Picard said leaves many outlets dispensing at a loss. He noted that 1,400 pharmacies had closed since 2020, with closures continuing at a rate of one or two per week.

Mark Samuels, chief executive of Medicines UK, which represents manufacturers supplying 85 per cent of NHS prescriptions, warned that the worst may be yet to come. "While the Iran conflict has not yet led to immediate or widespread medicine shortages for the NHS, this is due to stock already held in UK warehouses," he said. "As manufacturers move to replenish these stocks, transportation costs have risen by several hundred per cent, and some chemicals needed for manufacturing are in very short supply. If the conflict continues, we will inevitably see rising prices or shortages of essential medicines. This could be as soon as the next few weeks."

Some pharmacies have already stopped selling aspirin over the counter, partly reflecting supply constraints that predated the Iran war. While generic drugs are often cheaper at supermarkets and online pharmacies, analysts expect war-related cost pressures to push those prices higher too. Branded equivalents could see even steeper increases.