Rerouted cold-chain shipments raise hidden treatment risks for employer health plans
War in the Middle East is disrupting shipments of cancer medicines and other temperature‑sensitive drugs into the Gulf, as key air and sea transit hubs shut down and companies scramble to find alternative routes.
Reuters said the conflict, sparked by US and Israeli attacks on Iran two weeks ago and broadened by Iranian strikes around the region, has knocked out major airports in Dubai, Abu Dhabi and Doha, which are critical cargo hubs linking Europe with Asia and Africa.
PharmExec reported that Dubai and Doha in particular handle large volumes of temperature‑controlled pharmaceutical shipments through carriers such as Emirates and Etihad and logistics firms like DHL.
As per Reuters, Iran has also closed the Strait of Hormuz, making sea routes impractical because of both longer journey times and access restrictions.
PharmExec noted that this combination of airport closures and Strait of Hormuz restrictions is forcing drugmakers to reroute shipments of cancer treatments and other temperature‑sensitive medicines.
Industry data cited by Wouter Dewulf, a professor at the Antwerp Management School, show that more than a fifth of global air cargo – the primary route for critical and life‑saving drugs and vaccines – is now exposed to disruption in the Middle East.
Reuters added that the Gulf relies heavily on imports and that some medicines have short shelf lives and require strict cold‑chain storage, making lengthy overland shipping less practical.
Executives at Western drugmakers told Reuters they are seeking alternative routes into the Gulf and trucking some drugs overland from airports such as Jeddah and Riyadh in Saudi Arabia, with Istanbul and Oman as other options.
A medical device company executive said the first step was to map shipments already in transit or ready to depart, then decide which pallets needed diversion and whether new shipments had to be planned.
The same executive said some Europe–Asia cargo that typically moves through Dubai or Doha is now being rerouted via China or Singapore.
PharmExec reported that companies have set up internal teams to prioritise patient‑critical shipments, including cancer treatments, and rely on dry ice to maintain cold‑chain integrity over longer routes, which adds cost and complexity.
One executive cautioned that alternative "cold-chain corridors" could not be set up overnight and were not always available, Reuters said.
Another executive warned that some temperature‑controlled shipments could miss connections unless proper storage and handling were secured at each point along rerouted paths.
Prashant Yadav, senior fellow for global health at the Council on Foreign Relations, said typical stocks of short shelf‑life, temperature‑sensitive and more expensive medicines in the Gulf are usually around three months, with cancer drugs, particularly monoclonal antibodies, among those at highest risk.
Reuters reported that delays in delivery of oncology medicines can have dire consequences for patients, who might be forced to restart a course of therapy or see their cancer worsen, and that some customers have warned they could run low on supplies within four to six weeks if conditions do not improve.
Despite these pressures, some logistics providers say the industry is coping for now.
Dorothee Becher, in charge of air logistics for healthcare at Kuehne+Nagel, said carriers were flying into Jeddah, Riyadh and Oman and using land routes to reach final markets, and that she did not yet see a risk that inventory would “go dramatically down,” while healthcare cargo was being prioritised.
At the same time, Doaa Fathallah, chief operating officer at biopharma logistics company Marken, said cold‑chain cargo was getting through only with round‑the‑clock re‑routing as airspace restrictions shifted rapidly, which meant longer transit times, higher fuel costs, greater use of dry ice and rising transportation fees.
Executives also warned that shipping snags could affect items that pose indirect risks to drug supplies, including vial stoppers, IV bag plastics and other packaging components.
David Weeks, who follows the supply chain industry for Moody’s, told Reuters that medicine shortages sometimes arise from “the little stopper on the vial where the dosage is extracted,” not from “a shortage of the medicine itself.”
