April 5, 2026, 5:07 a.m. ET
Drug pricing watchdogs worry President Donald Trump‘s plan to assess 100% tariffs on some imported brand name drugs could lighten patients pocketbooks.
But that fate is far from certain, given caveats the Trump administration announced as part of a sweeping April 2 order on tariffs for imported brand name pharmaceuticals.
Drugmakers that agree to move production to the United States will face a 20% tariff while they transition and no tariff if they also agree to lower prices to “most favored nation” levels paid by other countries, according to the order. The full tariff will be levied if drug production isn’t in the U.S. in four years.
The tariffs assessed to larger drug companies will take effect July 31 unless companies commit to price concessions and bolstering domestic manufacturing. Smaller drug manufacturers will have until Sept. 29 to comply.
Merith Basey, CEO of Patients for Affordable Drugs, warned that terms of the most favored nation drug pricing deals already announced have “not delivered meaningful savings for the vast majority of American patients.”
“What Americans need is structural reform that will be long lasting,” Basey told USA TODAY. “What they don’t need is temporary, voluntary agreements that are opaque and unclear.”
She added Americans are already struggling with the price of everyday goods and “when it comes to lifesaving or essential medicines, any small increase on the cost of a drug you have to pay for monthly can have a significant impact.”
How has the Trump administration tacked drug affordability?
Trump has made most favored nation deals a centerpiece of his administration’s effort to lower drug prices for consumers.
The administration has announced deals with 16 of 17 major drug manufacturers that it sent letters to in 2025 seeking price concessions on brand name drugs. Regeneron, the only company that did not reach a most favored nation pricing deal, expects to reach a drug pricing agreement in the near future, a Regeneron spokesperson said.
While touting these deals as a boon for consumers during oval office announcements, the Trump administration hasn’t publicly released terms of the voluntary agreements. The administration’s drug-pricing website, TrumpRx, listed prices of more than five dozen brand-name fertility, insulin, weight loss and other medications as of April 2. The website doesn’t process insurance claims, instead directing cash-paying consumers to drug manufacturers websites or coupons that can be used at pharmacies.
Drug affordability remains a top concern
Most people with health insurance will likely use their plan’s drug benefits to fill prescriptions. Still, affordability is a concern for most Americans.
About 6 in 10 Americans said they are worried about being able to afford their prescription drug costs, according to a March survey from KFF, a nonpartisan healthy policy nonprofit. Four in 10 said they saved costs by skipping doses, not filling prescriptions or taking other cost-saving measures.
If pharmaceutical companies are assessed 100% tariffs on brand name drugs, they would need to at least double their prices to pay for the duties, said Antonio Ciaccia, CEO of 46brooklyn and a drug pricing expert.
Consumers and private health insurance plans would likely see the largest price increases under such a scenario, said Ciaccia, citing inflation penalties assessed when drug companies significantly raise prices for government health insurance programs Medicare and Medicaid.
“We end up paying for it one way or another,” Ciaccia said.
What’s excluded from the brand name drug tariffs?
While Trump’s order broadly applies to brand-name drugs and drug ingredients, it excludes generic drugs that represent about 9 in 10 prescriptions filled by Americans.
Generic drugs have lower profit margins and often include ingredients that are made overseas where manufacturing costs are typically less expensive.
“The generics and biosimilars industry applaud the administration for recognizing the unique aspects of our industry’s supply chain and exempting generic and biosimilar medicines from tariffs,” John Murphy III, president and CEO of the Association for Accessible Medicines, which represents generic drugmakers, said in a statement.
Murphy added the Trump administration understands the “savings and access provided to American patients, as well as the potential harms and unintended consequences associated with further burdening the economics of our industry in the U.S.”
The European Union, Japan, South Korea, Switzerland and the United Kingdom are exempt from the tariff due to existing trade deals with the United States.
A senior White House official said the tariff will help ensure the United States is not beholden to other countries for lifesaving drugs.
“The United States is heavily reliant on imports, threatening to limit United States access to life-saving medications in the event of global supply chain disruption due to geopolitical or economic disruption,” the order Trump signed April 2 states, adding that about 53% of patented drugs distributed in the U.S. are manufactured outside the country.
Contributing: Zac Anderson
