In Iran, the cost of treatment has increased to the point where it is no longer just an economic burden but has become a determining factor that decides who can continue their treatment and who has to abandon it. Direct payments from people's pockets account for about 43 percent of total health expenditure; a concerning figure that reflects the heavy burden of treatment on households.
Disease; The Economic Calculator
Therapeutic poverty means that the patient is not just a patient; they simultaneously become an economic calculator. They must choose between medication and rent, between tests and food costs, doctor visits and essential bills. In this situation, there is a prescription, there is a doctor, and there is a disease; but what is lacking is the ability to pay for treatment.
In such a situation, treatment is usually not eliminated, but parts of it are cut. A test is postponed, a visit is canceled, and the patient says, "I can manage for now." This "for now" is one of the most costly words in health economics.
The Drug Crisis and the Privatization of Disease Risk
The crisis intensifies when inflation and shortages occur simultaneously. In this situation, the patient faces two problems: either they have no money or the medication cannot be found. In these circumstances, the informal market and high-risk choices grow. Pharmacies also face long delays from insurers and increased costs of supplying goods, which puts them under pressure.
For this reason, the drug crisis cannot be limited to just a pharmacy crisis or an import crisis. Sanctions, inflation, and currency devaluation together lead to a decrease in people's actual access to treatment.
In an efficient health system, the patient should decide on the diagnosis and treatment method, not check their bank account beforehand. Ultimately, the real crisis is that the number of those who can afford treatment is decreasing, and medications are becoming more expensive, while the share of treatment in people's lives is becoming cheaper.
