Trump’s huge tariffs on some drugmakers could end up backfiring

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President Donald Trump’s order to levy 100% tariffs on certain patented pharmaceutical products and ingredients takes effect on Tuesday.

But experts question the extent to which the move will achieve its goal of spurring more drug manufacturing in the US. That’s because the burden will fall most heavily on small and midsize companies that generally don’t have the wherewithal to shift or expand production in America.

Instead, experts say, the tariffs could force these drugmakers to close or merge with larger rivals, which could in turn reduce the number of medications that they provide to patients and could lead to higher prices – which is the last thing Trump says he wants.

What’s more, the tariffs could dampen the discovery of new medicines since these smaller firms tend to be more innovative, some experts argue.

The tariffs were announced in April, but the president had long signaled that he would target the industry, which had largely escaped such levies for decades due to a longstanding international agreement designed to keep essential medicines flowing freely across borders.

However, there are many provisions and exceptions that will limit the tariffs’ impact. Notably, the levies won’t apply to the larger pharma companies that have signed “Most Favored Nation” agreements. These manufacturers have promised to beef up their domestic production, as well as provide their medicines at lower prices to Medicaid and TrumpRx , the administration’s direct-to-consumer clearinghouse. They make the vast majority of brand-name drugs.

Also, generic medications, orphan drugs for rare diseases and certain specialty medicines are largely exempt. Patented pharmaceutical products from the European Union , Switzerland, Japan and South Korea, which have existing bilateral trade deals, will be subject to a 15% tariff rate, while those from the United Kingdom will not be subject to the levies. And companies that have an agreement to produce more in the US will face a 20% tariff.

That leaves a small share of pharmaceutical manufacturers and their products that will be subject to the 100% tariff rate, industry analysts said when the levies were unveiled.

There are more than 100 drugmakers that make at least one drug that is not exempt, according to a preliminary analysis from the Brookings Institution. A majority of these companies do not have any production facilities – instead, they use contract manufacturers to make their medications, said Marta Wosinska, a senior fellow at Brookings.

There is a “crazy level” of competition for contract manufacturing capacity in the US, so it would be very expensive for these drugmakers to make more of their products domestically, she told CNN.

“Their pockets are not as deep,” she said of the smaller companies.

Many may have no choice but to sell themselves to larger players in the industry if they can’t negotiate deals with the White House, Wosinska said.

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Patients with conditions that aren’t treated by major pharmaceutical manufacturers could feel the biggest impact since they often depend on medications made by smaller companies. The prices of these medicines will likely rise, said Mollie Sitkowski, an international trade lawyer with Faegre Drinker. Plus, she expects there will be fewer new drugs released in coming years.

The Biotechnology Innovation Organization, which represents smaller and mid-sized drugmakers, wrote to the Commerce Department earlier this month warning that “tariffs that punish U.S. innovators are counterproductive and risk slowing the investment and innovation needed to be successful.”

“The reality is that tariffs on America’s medicines will raise costs, impede domestic manufacturing, and divert scarce resources away from research and development critical to maintaining American biotech leadership,” wrote John Crowley, BIO’s CEO.

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唐纳德·特朗普总统下令对某些专利药品和成分征收 100% 的关税，该命令于周二生效。

但专家质疑此举能在多大程度上实现其促进美国药品生产的目标。这是因为，最大的负担将落在中小企业身上，而这些企业通常缺乏将生产转移到美国或扩大生产规模的能力。

专家表示，关税反而可能迫使这些制药商关闭或与更大的竞争对手合并，这反过来可能会减少他们向患者提供的药品数量，并可能导致价格上涨——而这正是特朗普所说的他最不希望看到的。

此外，一些专家认为，关税可能会抑制新药的发现，因为这些规模较小的公司往往更具创新精神。

关税措施于 4 月份宣布，但总统早已表示将对该行业采取打击行动。由于一项旨在确保基本药物跨境自由流通的长期国际协议，该行业几十年来基本上免受此类关税的影响。

然而，许多条款和例外情况将限制关税的影响。值得注意的是，这些关税不适用于已签署“最惠国待遇”协议的大型制药公司。这些制造商承诺提高国内产量，并以更低的价格向医疗补助计划（Medicaid）和特朗普政府的直接面向消费者药品交易平台TrumpRx提供药品。它们生产了绝大多数品牌药。

此外，仿制药、罕见病孤儿药和某些专科药物大多免税。来自欧盟、瑞士、日本和韩国（这些国家与美国已签订双边贸易协定）的专利药品将被征收15%的关税，而来自英国的专利药品则无需缴纳关税。与美国签订增产协议的公司将面临20%的关税。

行业分析师在关税公布时表示，这意味着只有一小部分制药企业及其产品将受到 100% 关税的影响。

布鲁金斯学会的一项初步分析显示，有超过100家制药公司生产至少一种不属于豁免范围的药物。布鲁金斯学会高级研究员玛尔塔·沃辛斯卡表示，这些公司中的大多数没有自己的生产设施，而是委托代工厂生产药品。

她告诉 CNN，美国对合同生产能力的竞争“异常激烈”，因此这些制药商在国内生产更多产品的成本会非常高昂。

“他们的财力不如大公司雄厚，”她谈到小公司时说道。

沃辛斯卡表示，如果无法与白宫达成协议，许多企业可能别无选择，只能将自己出售给业内更大的企业。

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那些患有大型制药公司未研发出治疗方案的疾病的患者可能会受到最大的影响，因为他们通常依赖于小型制药公司生产的药物。费格雷·德林克律师事务所的国际贸易律师莫莉·西特科夫斯基表示，这些药物的价格可能会上涨。此外，她预计未来几年新药上市的数量将会减少。

代表中小型制药企业的生物技术创新组织本月早些时候致函商务部，警告称“惩罚美国创新者的关税会适得其反，并有可能减缓成功所需的投资和创新”。

“现实情况是，对美国药品征收关税将提高成本，阻碍国内生产，并将稀缺资源从对维持美国生物技术领先地位至关重要的研发领域转移出去，”生物技术创新组织（BIO）首席执行官约翰·克劳利写道。