From syringes to stents: Iran war exposes NHS dependency on petrochemicals | NHS

The war in Iran has put the NHS on high alert due to fears of looming shortages and rising costs of medicines and medical products such as syringes, intravenous bags and gloves.

Much of modern healthcare depends on petrochemicals, whether for active pharmaceutical ingredients or to produce millions of sterile disposable products, from personal protective equipment (PPE) to catheters and diagnostic device covers, which have been halted by shipping halts in the Gulf.

The NHS is one of the largest buyers of healthcare in the world. It spends £8bn a year on equipment and supplies, from latex gloves to paper towels, stents to prosthetic hips. Medicine bill arrived £21.6bn in 2024-25.

Temporary shortages of certain medicines and equipment are quite common and have worsened since Brexit and during the Covid-19 pandemic. But the Iran war now threatens to widen and deepen such shortages in the UK and globally, driving up costs and prompting scrambles for supplies across countries.

‘Big shock’

Jim Mackey, chief executive of NHS England, is “very concerned” about supply chain challenges and told the Health Service Journal that the NHS will need extra government funding if the war leads to a “major price rise shock”.

In response, NHS England increased purchases of medicines and devices to create a buffer. While there are currently no shortages due to its clout in supplying as a major single customer, this may change as the conflict drags on. Damage to energy infrastructure and mines in the Strait of Hormuz is likely to further prolong any disruption.

NHS Supply Chain is the central purchasing body for NHS trusts, managing the sourcing, delivery and supply of more than 620,000 products, from clinical supplies to medical equipment.

Head of endurance Tom Brailsford says stocks are being increased “where appropriate” and the organization is talking to suppliers about continuity plans and logistics routes.

Disruptions also continue at airports in the Middle East, with airlines cutting flights due to concerns about access to jet fuel. In normal times, Dubai and Doha are major hubs for air transport of medicines to Europe from India, known as the pharmacy of the world and where the majority of off-patent medicines are produced.

“You have the dual problem of knock-on issues around airspace and logistics chains,” says Richard Sullivan, professor of cancer and global health at King’s College London and director of the Cancer Policy Institute.

“When you look at supply chains, most cancer drugs are very thin and often rely on a single supplier. Movement of drugs and active ingredients [and equipment] It is definitely Byzantine. “You often see incredibly long supply chain lines… because they can be so much cheaper.”

‘Think twice about how much you use’

At the Gloucestershire Hospitals trust, doctors and nurses receive 67,653 boxes of synthetic rubber gloves a year (more than 6 million single gloves, totaling around £330,000). This has led to the launch of a campaign to reduce overuse in 2024. means war These rules for “correct use” – can be enforced more stringently – with greater focus on hand washing.

“Such extra elements are essential to the delivery of parts of our services,” says Liz Breen, professor of healthcare operations at the University of Bradford. “So knowing that we can process patients with catheters after surgery, knowing that we can undertake surgical procedures because we have gloves and PPE, these are all very small things but if they are lacking together they can cause problems.”

Sullivan says: “Overall the message on the NHS is: think twice about how much you use. If you’re used to flashing a few swabs you can halve that during the procedure. Don’t open disposables and think ‘Oh, I may or may not use them’, because once it’s opened you have to throw it away.”

He says there is too much waste in the NHS and shortages could force the health service to move towards more judicious use of disposables and preparing medicines only when needed rather than in advance.

Supply chains are fraying, prices are rising

The cost of many common medical supplies has increased since the start of the war. The average price of a box of 1,000 synthetic rubber gloves is now 40% higher at $29 (£21.50), according to Oong Chun Sung, a research analyst at CIMB Securities in Kuala Lumpur.

He and other analysts warn that continued disruption to supply chains could lead to glove shortages in late May.

This is due to the rising price of naphtha, a byproduct refined from crude oil that is used to make petrochemicals that form the basis of many healthcare products. In northwestern Europe, naphtha prices rose from around $560 per tonne in February to over $900 per tonne in April.

London-based Polyco Healthline, a major NHS contractor that supplies gloves, PPE and other products. increased its prices by 10.3% to 26.3% He signaled that the increases will continue as of April 1. Malaysian condom maker Karex, which also makes gloves, catheter and probe covers and is an NHS supplier, is increasing its prices by 20% to 30%.

Malaysian disposable glove manufacturers account for almost half of global production. Top Glove, the largest manufacturer which supplies the NHS through Polyco, said it would reflect cost increases of 50%, mainly due to higher nitrile latex prices.

According to Polyco, approximately 60% of naphtha used in Asia is sourced from or routed through the Middle East. The shortage caused shutdowns at Asian chemical manufacturers, who declared force majeure in their petrochemical supply chains, freeing them from contractual obligations due to uncontrollable events.

Olivia Steele, principal analyst for EMEA olefins at Wood Mackenzie, says European prices for polyethylene and polypropylene, also made from naphtha, roughly doubled between February and April.

The price of polyester fiber used to make surgical masks, gowns, drapes, wipes, dressings and bandages increased by 28% from the end of February to the end of March. It is expected that there will be a fiber shortage starting from the end of May.

The price of PET resin, used in medicine vials and blood and other fluid collection tubes, rose 55% from February to March, according to data firms Wood Mackenzie and Argus Media.

“I think some of that is probably reasonable, but there’s no question there’s price inflation,” Sullivan says. “This will make the things we have become increasingly expensive even more expensive, and we are already hearing that components such as arms for surgical robots will be in short supply in the next few months.”

The NHS pays the lowest prices globally but shortages could arise if manufacturers prioritize countries that pay more, experts warn.

Breen says: “In the face of this conflict, the NHS may have to pay higher prices for products. I think the NHS and the health department will be prepared for this. They will work out how much they will have to pay to get stock into the UK.”

Volatility and scarcity

As for shortages, drugmakers have eight weeks’ worth of drugs on hand, while equipment manufacturers also have buffer stocks. However, in many areas there are few suppliers; For example, the US company Baxter and the German Fresenius Kabi and B Braun Medical are dominant in the IV bag market.

“Incentives don’t necessarily have to be inventories, like syringes, for example… because those have traditionally always been available,” says Scott Lehmann, a supply chain expert at software and consulting firm Sphera.

“Volatility is a property of the system; it is not something that happens once in a blue moon,” he adds.

“But healthcare is completely different from other industries. Healthcare can’t stop because of a supply shortage; it’s not like, ‘Oh, we’re going to put the patient’s needs on hold for a while.’ It’s not a discretionary purchase.”

The “just-in-time” supply chains of the UK and other countries may come after them. Sullivan said Britain and the rest of Europe should be ready to invest and move production closer to the country.

Brailsford says NHS Supply Chain is working “closely with suppliers and system partners to minimize the impact of any cost pressures and ensure trusts do not need to unnecessarily change clinical practice.”

A spokesperson for the UK Department of Health and Social Care said: “We have robust measures in place to manage disruption to the health and social care sector to protect patients, including maintaining buffer stocks and purchasing alternative products where necessary.

“The vast majority of Britain [14,000] “The supply of licensed medicines remains good and we will continue to work closely with industry partners to ensure the continued supply of medical products.”