Frequently Asked Questions

On April 2, 2026, President Trump signed a proclamation imposing tariffs on pharmaceutical imports under Section 232 of the Trade Expansion Act of 1962 — the same authority used for steel and aluminum tariffs. The proclamation sets a default tariff rate of 100% on all patented brand-name prescription drugs manufactured outside the United States that don't have a specific exemption. The stated goal is to bring pharmaceutical manufacturing back to the United States and reduce dependence on foreign drug supply chains, particularly from China.

The 100% tariff applies to patented brand-name prescription drugs that: (1) are listed in the FDA Orange Book or Purple Book as subject to a valid, unexpired US patent, (2) are manufactured outside the United States, and (3) do not qualify for a country-specific exemption or MFN company deal. This covers a large portion of brand-name specialty drugs — biologics, cancer treatments, autoimmune drugs, and other high-cost medications — particularly those without US domestic manufacturing operations. Common examples include brand-name versions of drugs like Humira, Keytruda, Dupixent, Revlimid, and Xarelto where the manufacturer has not secured an MFN deal. If you are unsure about your specific medication, use the drug search tool on this site to check instantly.

No. Generic drugs and biosimilars are completely exempt from the Section 232 pharmaceutical tariffs, regardless of where they are manufactured. This is one of the most critical facts for patients to understand. Approximately 90% of all US prescriptions are filled with generic drugs, which means the majority of Americans are insulated from direct tariff impact. If your brand-name drug has an FDA-approved generic equivalent, switching to that generic — before or after the tariff takes effect — would completely eliminate your exposure to tariff-related price increases. Generic drugs must meet the same FDA standards for safety, efficacy, and quality as brand-name drugs. Your pharmacist can confirm whether a generic is available and whether your insurance covers it.

There are two effective dates. July 31, 2026 is the effective date for drugs from the 13 Annex III companies (AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, EMD Serono, Genentech, Gilead Sciences, Merck, Novartis, Novo Nordisk, and Sanofi). These companies have MFN deals and pay 0%, but the earlier date reflects their proactive cooperation. September 29, 2026 is the effective date for all other pharmaceutical companies — this is when the 100% default tariff begins for non-exempt brand-name drugs without deals.

MFN stands for Most Favored Nation. An MFN deal is a bilateral agreement between a pharmaceutical manufacturer and the US Department of Health and Human Services under which the company agrees to (1) offer Americans their lowest global drug prices, and (2) invest in US domestic manufacturing capacity. In exchange, the company's drugs are exempt from the tariff at a 0% rate. As of April 2026, 13 companies have signed MFN deals: AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, EMD Serono, Genentech, Gilead Sciences, Merck, Novartis, Novo Nordisk, and Sanofi. These agreements expire January 20, 2029 unless renewed.

Not necessarily in the short term, but potentially over time. The tariff applies to the drug's acquisition cost — what manufacturers charge pharmacies — not directly to your insurance copay. In the short term, your copay is set by your insurance plan and may not change immediately. However, as manufacturers' costs rise, insurance companies may respond by: increasing drug formulary tiers (which raises your copay), removing the drug from formulary altogether, or increasing premiums to offset higher costs. Patients paying out-of-pocket or those in high-deductible plans will likely see the most direct and immediate impact.

NADAC stands for National Average Drug Acquisition Cost. It is a weekly survey published by the Centers for Medicare & Medicaid Services (CMS) that measures the average price pharmacies pay to purchase drugs from manufacturers or wholesalers. It represents the drug's cost before pharmacy markups, dispensing fees, or insurance adjustments. NADAC is the most reliable publicly available measure of drug acquisition costs and is used here as a baseline for estimating tariff impact. Because NADAC reflects the wholesale acquisition cost, it is the most direct measure of where a tariff would first hit the supply chain. Your actual out-of-pocket cost will depend on your specific insurance plan, copay structure, and whether your insurer absorbs or passes through the cost increase.

Biosimilars are drugs that are highly similar to FDA-approved biological products (biologics) whose patents have expired. They are the biologic equivalent of generic drugs for small-molecule medications. Like generics, biosimilars are fully exempt from the Section 232 pharmaceutical tariffs, regardless of where they are manufactured. Examples include biosimilars to Humira (adalimumab biosimilars like Hadlima, Hyrimoz, and Cyltezo), Herceptin (trastuzumab biosimilars), and Rituxan (rituximab biosimilars). Biosimilar approvals are tracked in the FDA Purple Book, which is publicly searchable. If your biologic medication has an approved biosimilar on the market, switching could provide complete tariff exemption and often results in significant cost savings even without a tariff.

The Section 232 proclamation creates 6 distinct tariff tiers: (1) 100% — Default for brand-name patented drugs with no deal; (2) 20% — Companies with approved US onshoring plans; (3) 15% — Drugs manufactured in EU, Japan, South Korea, Switzerland, or Liechtenstein; (4) 10% — Drugs manufactured in the United Kingdom; (5) 0% deal — 13 Annex III companies with MFN pricing agreements; (6) 0% exempt — All generics, biosimilars, orphan drugs, nuclear medicines, plasma-derived therapies, fertility treatments, cell and gene therapies, antibody drug conjugates, and CBRN countermeasures.

Several categories of drugs are explicitly exempt from the tariff regardless of patent status or manufacturer deal: orphan drugs (approved for rare diseases with fewer than 200,000 patients in the US), nuclear medicines and radiopharmaceuticals, plasma-derived therapies (like immunoglobulins, albumin, and clotting factors), fertility treatments, cell therapies and gene therapies, antibody-drug conjugates (ADCs), and drugs designated as Chemical, Biological, Radiological, and Nuclear (CBRN) countermeasures. These exemptions reflect the unique supply chain constraints and public health considerations for these specialized drug categories. Patients taking any of these drug types can be confident they fall under the 0% specialty exempt tier, regardless of who manufactures them or where. Use the drug search tool to confirm your specific medication's exempt status.

The best way to find a generic equivalent is to check the FDA Orange Book for small-molecule drugs or the FDA Purple Book for biologics — both are free public databases. You can search by brand name to see if any generics or biosimilars have been approved. Your pharmacist is also an excellent resource: they can confirm in seconds whether a generic exists and is in stock at your pharmacy. Many pharmacy benefit managers also offer formulary lookup tools through your insurance portal. Additionally, this website's drug search will flag when a known generic equivalent exists for common brand-name medications. Given that the tariff takes effect July–September 2026, now is a smart time to proactively ask your doctor about available generic alternatives.

If you can't find your drug's manufacturer in the MFN deal list and don't see a country-of-manufacture exemption, the conservative assumption is the 100% default tariff will apply starting September 29, 2026. However, pharmaceutical companies have time to negotiate deals before that date, and new agreements may be announced in the months ahead. The situation is fluid — we update this site as new company deals are confirmed. In the meantime, we recommend two practical steps: (1) use this site's drug search to check the most current tariff status for your medication, and (2) ask your doctor now whether a generic or biosimilar alternative exists that would be completely exempt from the tariff regardless of what happens with negotiations.