Devastating Trade War Threatens Drug Access and US Patient Survival

Devastating Trade War Threatens Drug Access and US Patient Survival

The ongoing trade war between the United States and China is not just a political and economic clash. It is now threatening to shake the core of the American healthcare system.

Experts are raising the alarm. If pharmaceutical imports are not carved out from the escalating tariffs, drug prices could explode. The consequences could be deadly.

President Donald Trump launched the tariff war to counter what he called China’s unfair trade practices. President Xi Jinping fired back with retaliatory levies.

So far, both nations have taken turns slapping tariffs on hundreds of billions worth of goods. But now, the battlefield is shifting to a critical front—medicine.

America imports nearly 75% of its essential medicines. That includes drugs for infections, chronic diseases, and cancer. A huge chunk of those imports come directly from China—or indirectly through countries that rely on Chinese-made raw ingredients.

The US government, under the Trump administration, started investigating the medical supply chain. Officials said relying too heavily on other countries for medicine poses a national security threat.

They’re not bluffing. Sectoral tariffs from 7.5% to as high as 100% are being considered. This is on top of the already existing 145% tariffs on China.

Pharmaceuticals had been excluded from these tariffs—so far.

But that exception may not last.

And once these tariffs hit drug imports or their ingredients, patients will feel the pain.

It won’t happen overnight, though. Medicines don’t work like electronics or fast food.

There’s a built-in delay before tariffs affect the price you pay at the pharmacy. The drug supply chain is long and complex. Many companies keep stockpiles. Wholesalers and drugmakers also have reserves. Even the US federal government has emergency drug stocks.

Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health and Health Policy, says many pills are stable and can be stored for a long time.

That gives companies time to act. For now, big drug manufacturers and hospitals can absorb the extra cost. They did something similar during the COVID-19 pandemic.

But how long they can keep swallowing those costs is the million-dollar question.

Major players like AstraZeneca, Eli Lilly, and Johnson & Johnson have already expressed fear.

At a shareholder meeting, AstraZeneca Chairman Michel Demare said:

“We still strongly believe that medicines should be exempted from any kind of tariffs because, at the end, it is just harming patients’ health systems and restricting health equity.”

The company refused to say more. But their concern is clear.

The fear is real across the pharmaceutical world.

While India supplies about half of all the generic drugs used in the United States, it still depends on China for 80% of the raw materials—called Active Pharmaceutical Ingredients (APIs).

That means any blow to China is also a blow to India—and by extension, to Americans.

Generic drugs are usually 80–85% cheaper than brand-name drugs. That’s what makes them a lifeline for low-income and middle-class Americans.

Michael Abrams, a partner at the consulting firm Numerof and Associates, says generic drug makers work on razor-thin margins. They can’t afford to absorb big costs.

“If there’s a place where you save money, it is generic, and that’s exactly where the increases will be,” Abrams warned.

A recent report by ING showed a disturbing picture. A 25% tariff on pharmaceuticals could make cancer patients pay up to $2,000 more for a 24-week supply of their medicine.

That is not just a minor bump. It’s a massive wall.

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If generic companies leave the US market, it will trigger a wave of drug shortages.

Tom Kraus from the American Society of Health-System Pharmacists (ASHP) said tariffs could push manufacturers out of business or out of the country.

Kraus didn’t hold back:

“Imposing tariffs on medications and their ingredients could force generic drug manufacturers with already slim profit margins to drop out of the US market for a given medication, resulting in drug shortages for American patients.”

That’s not a theory—it’s a likely scenario.

Already, 90% of prescriptions filled in American pharmacies are for generics or biosimilars. If these vanish or shrink in supply, prices will go up and access will go down.

That leads to a dangerous snowball effect.

Insurance companies may cover less of the cost. Premiums could go higher. More of the burden gets dumped on the patient.

Professor Lee explains why this is serious:

“Demand for many pharmaceuticals is not flexible. This is not a consumer good. When you impose something that increases the cost, like the tariff, you can’t really change the demand … and will ultimately hurt patients.”

That pain won’t be spread equally. Low-income Americans will suffer the most.

According to supply chain data from Exiger, the US depends on China for 80% of active drug ingredients. For antibiotics, that number jumps to 90%.

That’s a hard pill to swallow for anyone on a tight budget.

And many Americans are already drowning in medical bills.

One in three people in the US say they skip taking prescribed medications because of the cost. About 11% say they simply can’t afford healthcare at all. For Hispanic adults, that number jumps to 18%.

And then there are the uninsured—about 7.7% of Americans. For them, there’s no safety net. Every penny is out of pocket.

Even insured patients aren’t safe.

If Trump’s pharmaceutical tariffs go through, public health experts say insurance companies will pass those costs on to policyholders.

Bruce Y. Lee put it plainly:

“They’re going to spread that out among anyone paying insurance as a whole. That’s the whole concept of insurance.”

And it’s not just Chinese drugs under threat.

Medicines made in Europe could become more expensive too. There’s already a 10% tariff on some of these drugs, and that could go even higher.

That’s a serious hit when you consider that blockbuster medications, like Eli Lilly’s weight-loss drug Zepbound, are produced in Ireland.

If tariffs hit those products, the cost could jump to over $1,000 per month without insurance—compared to $25 with insurance.

The American Hospital Association (AHA) sent a clear message to the White House in February. They warned that tariffs will worsen existing supply chain issues.

Their letter said:

“US providers import many cancer and cardiovascular medications, immunosuppressives, antibiotics, and combination antibiotics from China. For many patients, even a temporary disruption in their access to these needed medications could put them at significant risk of harm, including death.”

The AHA didn’t offer further comments when asked again.

But their concern is echoed across the industry.

Healthcare logistics are already fragile. Some ingredients go through two or three different countries before they even reach the US.

Disrupt that chain, and you delay or destroy the final product.

Right now, there are 104 active drug shortages in the US. That includes antibiotics like amoxicillin.

China is one of the top three exporters of this medicine. And the US is the largest importer.

That’s a dangerous dependency.

Even worse, the Chinese API market is slowing down. It’s expected to grow by just 7.8% over the next five years, according to Modor Intelligence.

That means less supply is coming, even as US demand stays high—or increases.

If tariffs rise, stock prices fall. Big pharma companies then scramble to raise prices to satisfy their shareholders.

They’re not in the business of losing money.

This could mean even costlier drugs, insurance hikes, and a healthcare system stretched to the limit.

Patients will be left paying more. Many will be forced to go without. And lives will be lost—not because of disease, but because of politics and policy.

The warning signs are everywhere.

The question is, will the US government listen before it’s too late?