How The Strait Of Hormuz Crisis Is Stalling U.S. Medical Breakthroughs
By Beenish Rasheed
As a supply chain professional, I often find myself wondering how many people, resources, and industries collaborate to produce everyday goods that we use. Every product that reaches the consumers goes through an intricate background process of trial and error before reaching its most effective final form and being released as a safe and reliable commodity. Few products, however, carry stakes as high as the drugs developed and tested through clinical trials.
In the high-stakes world of pharmaceutical research, the journey from a laboratory concept to a lifesaving treatment is governed by a rigorous process of clinical trials. These trials are scientifically driven, phased processes, each requiring a constant, uninterrupted supply of investigational medicinal products (IMPs).
This is where supply chain integrity becomes critically important for the pharmaceutical industry.
IMPs are often experimental drugs, and contrary to commercially available medications, are produced in small batches, with extensive contractual obligations and often at a significant financial risk to the sponsor. While the U.S. is the global leader in clinical research, it does not manufacture the majority of its trial materials domestically. Major U.S.-based suppliers like Thermo Fisher Scientific (Patheon), Catalent, and Cencora manage the final packaging and distribution of trial kits. However, these firms depend on active pharmaceutical ingredients (APIs) and chemical precursors sourced primarily from Asia – mainly India and China.
The disruption of shipping through the Strait of Hormuz is affecting clinical trial supply in two key ways. First, it impacts the availability of raw materials required for drug manufacturing and, subsequently, the production and global distribution of IMPs. A significant portion of the raw materials required for complex molecules is transported through the Strait of Hormuz, making clinical supply chains in Asia particularly exposed to disruption. As IMPs are produced on a just-in-time basis, companies are less likely to inflate their inventories unless absolutely necessary, increasing their exposure to disruption.
The second challenge is the distribution of these drugs to clinical trial sites globally. Often pharmaceutical products are temperature controlled, and the closure of Strait of Hormuz has increased the shipping cost by 200%-400% in some case.1 When goods are rerouted via the Cape of Good Hope – which is the best alternate for safe delivery of products – transit times can increase by 10 to 15 days. Shipping through air directly adds extra cost of freight, not to mention the inflated fuel and insurance costs.
These disruptions can create a snowball effect across clinical trial phases. The first impact is on the integrity and availability of trial kits at the site level. With increased transit times, the risk of temperature excursions rises, potentially resulting in the loss of already limited supply of investigational drugs.
When an IMP kit fails to arrive at a clinical site, the trial phase is disrupted. Since many necessary trial kits may be delayed in transit or affected by manufacturing slowdowns, trials in later phases can face enrollment delays and increased operational strain on sponsors. This impact is more profound in drugs that are being developed for chronic diseases. In some cases, missed or delayed dosing can compromise protocol adherence, potentially affecting data integrity and study timelines. Months of diagnostic research could suddenly be rendered unreliable.
The impact of these delays is measured in more than just time; it is measured in financial loss and human health. According to 2025-2026 Tufts Center for the Study of Drug Development (CSDD) analysis,2 the operational cost borne by a pharmaceutical sponsor when a trial phase is delayed is more than $50,000 per day. More significantly, every day of delay at the clinical stage is a day of lost revenue at the end of a drug’s patent life.
Recent disruptions in the Strait of Hormuz have highlighted the vulnerability of U.S. clinical trials to global shipping chokepoints. While the industry is exploring near-shoring and increased domestic API production, these adjustments take time to implement. Clinical supply teams may need to reassess sourcing strategies, build additional buffer stock where feasible, and evaluate alternative distribution routes to mitigate risk. In the immediate term, the disruption in Asia is stalling the next generation of medical breakthroughs, proving that in the modern world, a chokepoint in the Persian Gulf can directly influence the treatment options available in an American doctor's office
For clinical supply professionals, understanding these challenges is only the first step. Teams can mitigate risk by proactively diversifying sourcing, strategically managing IMP inventory, and preparing alternative distribution routes to maintain timely delivery. Close coordination across clinical operations, logistics, and supply planning ensures protocol adherence and protects temperature-sensitive materials, while ongoing attention to geopolitical and regulatory developments allows teams to anticipate and respond to emerging risks. In this way, even amid global disruptions, investigational therapies can continue to reach patients efficiently, intact, and on schedule.
References:
- Hargreaves, L. (2026). How US-Iran Conflict is Reshaping Global Supply Chains. Supply Chain Digital.
- Smith, Z. P. (2025). New estimates on the cost of a delay day in drug development. Therapeutic Innovation & Regulatory Science.
About The Author:
Beenish Rasheed is a global trade compliance expert and licensed Doctor of Pharmacy from Pakistan. She worked as senior manager regulatory compliance with the federal government of Pakistan and possesses over eight years of experience navigating global trade governance and industrial operations. Her work sits at the intersection of technical chemical integrity, international trade policy, and data-driven climate resilience. Leveraging her expertise in the U.S. clinical supply chain’s reliance on Asian API manufacturing and Middle Eastern transit corridors, she provides essential insights into how geopolitical disruptions directly impact medical breakthroughs and patient care.