The pharmacists have the most common drugs on hand
How much is the most favored nation pricing in the U.S.? Physicians confront the Trump administration with tariffs on drugs and a defensive wall
Trump originally signed an executive order on most favored nation pricing in late 2020 during his first term that would have tied Medicare Part B drug prices to those in other countries. The executive order was dropped by the Biden administration after facing court challenges. On the campaign trail last year, Trump said that he would bring back the most favored nation executive order from 2020 but there was no video on his website.
During the White House announcement, Dr. Mehmet Oz, who leads the Centers for Medicare and Medicaid Services under Trump, pointed out that even the lower negotiated Medicare prices are higher than what people pay in Europe for the same products. Half the time we are paying more than we are in other countries. It doesn’t make any sense for the system.”
Meanwhile, pharmacists predict even the 10% tariffs Trump has demanded will hurt: Jolley said a potential increase of up to 30 cents a vial is not a king’s ransom, but it adds up when you’re a small pharmacy that fills 50,000 prescriptions a year.
The new executive order has multiple parts. It directs the U.S. Trade Representative and Department of Commerce to take action against “unreasonable and discriminatory policies” that lower drug prices abroad, though it’s not clear what authority the White House has in this regard. It also directs Health and Human Services Secretary Robert F. Kennedy Jr. to facilitate direct–to-consumer sales that bypass health insurance at lower prices.
Trump said that “we’ve been subsidizing other countries throughout the world” by paying higher prices.
Patients in the U.S. pay more for drugs than their counterparts in other countries because of government-set prices that they don’t like. Drug companies have more freedom to set prices in the U.S. because the US doesn’t set prices.
In the basement of a Salt Lake City pharmacy, there are hundreds of bottles stacked in rows, one man’s defensive wall in a tariffs war.
Jolley bought six months’ worth of the most expensive large bottles, hoping to shield his business from the 10% across-the-board tariffs on imported goods that President Trump announced April 2. Now with threats of additional tariffs targeting pharmaceuticals, Jolley worries that costs will soar for the medications that will fill those bottles.
Jolley said it makes sense to push manufacturing from China and India to the U.S. In the event of war, China could quickly stop all exports to the United States.
He said that they are not going to go back and say, “Here’s your 10% boost because of the 10% tariff.” “Costs are gonna go up and then the sluggish responses from the PBMs — they’re going to lead us to lose more money at a faster rate than we already are.”
Pace said tariffs could be the death knell for the many independent pharmacies that exist on “razor-thin margins” — unless reimbursements rise to keep up with higher costs.
“Big ships don’t change course overnight,” said Robin Feldman, a UC Law San Francisco professor who writes about prescription drug issues. It will take time to get manufacturing up and running, even if companies promise to bring it home. The key will be to avoid any harm to consumers in the process.
“When they hear that, they will leave China,” he said. The United States imported $213 billion worth of medicines from China in the year 2024.
Scott Pace is a co-owner of a Little Rock pharmacy and he says that tariffs are uncertain right now.
U.S. Pharmacists Stockpile Generic Drugs on Chance of Targeted Trump Tariffs: “I Know There’s a World,” says Murphy
He said that he put 90 days’ worth of the top 200 generics on the shelf as a starting point. “Those are the diabetes drugs, the blood pressure medicines, the antibiotics — those things that I know folks will be sicker without.”
Patients aren’t able to pass along the costs of their healthcare to the pharmacy. Their payments are set by health insurers and pharmacy benefit managers largely owned by insurance conglomerates, who act as middlemen between drug manufacturers and purchasers.
“You’ve got real estate in North Texas that’s cheaper than real estate in Shenzhen,” he said at an economic conference April 25 in Washington, referring to a major Chinese chemical manufacturing center.
Several U.S. generics firms have declared bankruptcy or closed U.S. factories over the past decade, said John Murphy, CEO of the Association for Accessible Medicines, the generics trade group. Reversing that trend won’t be easy and tariffs won’t do it, he said.
He has been trying to explain these things to Trump officials. Murphy said that the trade group was not called “PHRMA” but “We are not.” I can’t go to Mar-a-Lago to talk to the president on my own.
Tariffs on biosimilars coming from overseas — where Fresenius makes such drugs — would further incentivize U.S. use of more expensive brand-name biologics, the March 11 letter said. The cost of a biosimilar in the US is usually ten times greater than the original drug’s price.
European governments tend to establish more stable contracts with makers of generics, while in the United States, “rabid competition” drives down prices to the point at which a manufacturer “maybe scrimps on product quality,” said John Barkett, a White House Domestic Policy Council member in the Biden administration.
Source: Pharmacists stockpile most common drugs on chance of targeted Trump tariffs
Managing the emotional roller coaster of medical research: How a patient can make the most of his health care experience with the KFF Health Newsroom
He wondered how he could solve the problem of caring for his community while not having to worry about the emotional roller coaster of prescriptions being lost or profited.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.
US President Donald Trump has threatened to impose a 10% tariff on “most favoured nation” drugs, which include drugs used to treat cancer, heart disease and diabetes. Trump had in 2020 signed an executive order on “most favoured nation” pricing which would have tied Medicare Part B drug prices to those in other countries.