For people who rely on certain prescription drugs, including weight loss, asthma and cancer drugs, 100% prices of President Donald Trump on foreign brand medicines are not clarity at the time – or if – drugs may see price increases.
“From October 1, 2025, we will impose a 100% rate on any brand pharmaceutical or patented product, unless a company builds its pharmaceutical manufacturing plant in America,” said Trump on Truth Social Thursday evening. “” Construction “will be defined as,” noisy “and / or” under construction “. There will therefore be no rate on these pharmaceutical products if the construction has started. »»
Experts say that Trump’s position raises many questions. Here are five big ones.
What drugs will be affected?
Trump’s position does not specify whether the manufacturers of brand medication with an existing American factory would be exempt, if this exemption would include all their products, or if it would only be for drugs made on the American site.
Novo Nordisk and Eli Lilly, manufacturers of Wegovy and Zepound Weight Loss Medicines, respectively, announced its intention to invest in American manufacturing. But it is not clear if their intention to invest will justify an exemption.
On Tuesday, Lilly announced plans for a manufacturing installation of $ 6.5 billion in Houston which will produce Zepbound and his other drug GLP-1, Mounjaro, following a recent commitment to build a factory of $ 5 billion near Richmond, Virginia. Novo Nordisk, a Danish company, said in June that it would spend 4.1 billion dollars to build a second GLP-1 finish factory in Clayton, North Carolina.
Astrazeneca, which manufactures the drug at Asthma Symbicort, also announced in July that it will invest $ 50 billion over the next five years to extend its research and development and manufacture of footprint in the United States
Many other popular brand drugs, however, are mainly manufactured abroad, in particular in Europe, said Rente Conti, an associate professor at the University of Boston’s University of the University of Boston.
Botox, manufactured by allergens, and the Maginker Merck Keytruda cancer medication are made in Ireland. (Keytruda’s manufacturing has more and more moved to the United States in recent years, but it is not clear if it would earn an exemption from Trump prices.)
Others, including some for blood and lung cancers, as well as vaccines, are made in places like India and China, said Conti.
“I think what is most at risk here are brand products that come from China and India,” she said. The EU and Japan already have trade agreements in place that cover pharmaceutical products, she added, and it is not clear if the new price will replace it.
Will patients see prices increase?
Only 1 in 10 of the prescriptions completed in the United States concern brand medicines; The vast majority concern generics, which are much cheaper and will not be affected by these prices.
The question of whether patients see price increases will depend on the number of drug manufacturers receive exemptions – and to know if companies choose to pass these costs from the Pharmacy Comptoir patients, said Dr. Aaron Kesselheim, professor of medicine at the Harvard Medical School.
“In the end, the prices are taxes on patients,” said Kesselheim, “and as far as pharmaceutical companies see an increase in costs due to prices, they will transmit these costs to patients.”
Some companies may decide not to transmit costs. Until now, the 15% prices on EU imports have not translated into large price increases for American patients, noted Conti. Admittedly, a 100% price would be much more expensive for a business.
Price increases may not start right away, as drug manufacturers discover if they are eligible for an exemption. There could also be a discrepancy because US law prevents drug manufacturers from increasing the price of medication faster than inflation.
“What if you make factory updates that you currently have? And if you plan an installation? Kesselheim said. “Everything is very ambiguous.”
Some patients may not notice additional price increases at all, given that brand medicines are already expensive in the United States, Arthur Caplan, chief of the Nyu Langon Center medical ethics in New York said.
“I can certainly predict that some patients will immediately feel price increases that will shock them on some of these drugs,” said Caplan.
Could insurers absorb the costs?
Insurers and intermediaries, known as pharmacy services, could try to negotiate drug manufacturers or absorb some of the costs related to prices, said Caplan.
It is more likely that they transmit it to short-term patients, potentially in the form of greater copyization, he said.
It is not only patients with private insurance who should worry about price increases, said Kesselheim. Those who get their drugs covered by government health programs may also see price increases.
“The government is the largest buyer of prescription drugs on the market, via Medicare, Medicaid and VA, it is therefore really the government or the payers of the government who will see the greatest impact on price increases,” he said.
Will prices stimulate more manufacturing of American drugs?
It is unlikely, said Kesselheim. The decision to build a “is complicated and expensive” factory which requires several regulatory obstacles and years of planning.
Conti noted that when new manufacturing factories are completed, Trump is probably out of power.
“It is between two years and five years to have new production facilities built,” she said, “and it can be in millions of dollars depending on whether the product you make is a drug with a small molecule or a biological.”
Even putting money back in an existing factory is not fast.
“If you want to change lines or reissue a factory to make a product, we are talking about 18 to 36 months to do so,” said Conti, “because you have to show the American regulator that you can do at this large-scale factory, and the product is what it says, or is high quality and meets quality standards of the United States”
In a statement, Alex Schriver, spokesperson for the commercial group The Pharmaceutical Research and Manufacturers of America, said that “the most innovative drugs prescribed in America are already manufactured in America” and companies continue to invest in the United States
“The prices risk these plans because each dollar spent on prices is a dollar that cannot be invested in American manufacturing or the development of future treatments and remedies,” said Schriver. “Medicines have always been exempt from prices because they increase costs and could cause shortages.”
What about shortages?
If Trump focuses only on brand medication, American patients are unlikely to deal with shortages, Kesselheim said.
“Their profits are so far, so far beyond this price cost that they could probably be OK or increase drug prices,” he said. “They would probably not stop production accordingly.”
But that excludes, he added, some small businesses that can make brand slots products and that may not have the resources to take additional costs. If the prices extend to generics, the risk is much higher, added Caplan.
Unlike brand drugs, generic drugs are generally sold at the cost they have made, he said, which makes companies difficult for companies to justify the cost of building a new installation. They would probably be forced to move away from the production or to completely close their plants.
