On April 2, 2026, President Trump signed a presidential proclamation invoking Section 232 of the Trade Expansion Act of 1962 to impose tariffs on pharmaceutical imports. The move, unprecedented in its scope, has sent shockwaves through the healthcare industry and left millions of patients wondering: will my prescription cost more?
What the Tariff Actually Does
The Section 232 pharmaceutical tariff imposes import duties on patented brand-name prescription drugs — the kind you need a doctor's prescription to buy and that are protected by at least one valid US patent. The default rate is 100%, meaning drugs could double in their cost basis overnight.
But the tariff is not one-size-fits-all. There are six distinct tiers:
- 100% — The default for brand-name drugs with no special status
- 20% — Manufacturers with approved US onshoring plans
- 15% — Drugs made in the EU, Japan, South Korea, Switzerland, or Liechtenstein
- 10% — Drugs made in the United Kingdom
- 0% (deal) — 13 major companies with MFN pricing agreements
- 0% (exempt) — All generics, biosimilars, and several specialty categories
The most important fact for most patients: generics and biosimilars are completely exempt. Since approximately 90% of all US prescriptions are filled with generics, the majority of patients may be insulated from the tariff's direct effects.
The MFN Deal Companies
The Trump administration negotiated pre-emptive deals with 13 major pharmaceutical companies before signing the proclamation. These "Annex III" companies — AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, EMD Serono, Genentech, Gilead Sciences, Merck, Novartis, Novo Nordisk, and Sanofi — agreed to offer Americans "Most Favored Nation" pricing (the lowest prices they offer anywhere in the world) and to invest in US manufacturing.
In exchange, their drugs pay 0% tariff. Ironically, they face an *earlier* effective date — July 31, 2026 — compared to September 29 for other companies, because their deals are already structured.
When Does It Take Effect?
July 31, 2026 — Tariffs take effect for the 13 Annex III companies (0% rate under their MFN deals).
September 29, 2026 — The 100% default tariff takes effect for all other brand-name patented drugs without specific exemptions.
This gives patients with non-exempt drugs roughly five months from the proclamation date to prepare — enough time to explore generic alternatives, patient assistance programs, or 90-day supply stockpiling.
What Should Patients Do Now?
1. Check your drug — Use our drug search tool to instantly see your drug's tariff tier.
2. Ask about generics — If your drug has a generic, ask your doctor to switch. Generics are fully exempt.
3. Find patient assistance — Programs like NeedyMeds and RxAssist offer free or reduced-cost brand-name medications regardless of tariff status.
4. Consider a 90-day supply — Before July 31 or September 29 (depending on your manufacturer), ask your doctor for a 90-day fill to lock in current pricing.
The Section 232 pharmaceutical tariff is historic in scope, but its impact on individual patients will vary enormously based on which drug they take. The worst-affected will be patients taking brand-name specialty drugs from companies without MFN deals and without generic alternatives. The best-positioned patients are those already on generics — who face no tariff impact whatsoever.