Ever since President Donald Trump started promising to slap tariffs on pharmaceutical imports, drugmakers have unveiled a flurry of commitments to build or expand US manufacturing operations in the coming years.
AstraZeneca is investing $50 billion to expand its drug manufacturing in the US. Johnson & Johnson is pouring $55 billion into domestic production and research. And Eli Lilly said it will spend $27 billion to build four new manufacturing plants here.
In total, the planned investments exceed $250 billion, according to two industry analysts.
Trump is wielding the threat of tariffs to get drugmakers to increase their domestic production, which he says will strengthen national security. He’s also pushing pharmaceutical companies to reduce their prices, one of his longstanding goals.
But the pharma companies’ moves are not expected to decrease the United States’ reliance on foreign sources for key pharmaceutical ingredients and drugs, experts say. Nor are they likely to result in lower costs for American consumers.
Still, the White House regularly touts the steady drumbeat of commitments as proof Trump’s strategy is working.
“Another win for American manufacturing. @AstraZeneca’s $50 billion pledge to expand U.S. manufacturing and R&D shows our tariff strategy at work,” Commerce Secretary Howard Lutnick posted on X in late July. “The investment will bring high-paying jobs to Virginia, Indiana, Texas, and across the country while hardening our supply chains. Reshoring pharma production is one of our top priorities.”
But it’s just not that simple.
Complex supply chain
The pharmaceutical industry is a global web, with ingredients and finished drugs being manufactured in a multitude of locations around the world. The economics of brand name and generic drug manufacturing vary widely, and the price that the US consumer ultimately pays is determined by multiple players and factors.
Both American and foreign drugmakers already produce many medications in the US and have been investing in their operations here for years.
The prospect of tariffs certainly has prompted some brand-name manufacturers to shift more production to the US. However, some of the investments were already in the works before Trump took office, and other commitments may never be fulfilled, analysts say.
Johnson & Johnson’s $55 billion investment announcement in March, for instance, included the building of a North Carolina facility that was originally unveiled in October.
“They are just reiterating it because they’re probably trying to make sure that the president is aware that they have manufacturing here and that they are listening to him,” Evan Seigerman, senior biopharma analyst at BMO Capital Markets, said of pharmaceutical companies. “They’re playing ball. It’s all about the deal with President Trump.”
Generic drugmakers, however, are not making the same types of commitments – largely because they can’t afford to, as their profit margins are much thinner. While certain generic medicines are made in the United States, including sterile injectable drugs, oral liquid medications and controlled substances, the majority of drugs in pill or capsule form are produced abroad, primarily in India.
But two generic drug manufacturers have announced domestic investments in recent months, according to the Association for Accessible Medicines, a trade group for the generic and biosimilar drug industries.
Hikma Pharmaceuticals USA said it would invest $1 billion by 2030 to expand its manufacturing and research and development capabilities in several US locations, while Amphastar Pharmaceuticals said it would quadruple its production in the next three to five years. They both manufacture sterile injectable drugs, among other products.
Other companies are more hesitant.
“We’re not sure the market will support it if we build it,” said John Murphy III, the industry association’s CEO, noting that reimbursements are so low that companies may not get returns on their investments.
Much of the national security concerns center on generic drugs, which account for more than 90% of US prescriptions and are also critical to medicine administered in hospitals and doctors’ offices. A sizeable share of the supply chain for certain generic medications comes from abroad and could be disrupted during geopolitical crises, a risk that’s been repeatedly flagged by a bipartisan group of senators.
Blanket tariffs, however, won’t spur more domestic manufacturing of these drugs, said Erin Fox, associate chief pharmacy officer at the University of Utah Health.
“It’s highly, highly unlikely we will see generic production expand in the US without significant incentives for these companies,” she said.
“If we do move production on some drugs to the US because we want to be sure from a national security standpoint, that’s fine, but that’s going to cost money.”
Just what tariffs the pharmaceutical industry will face – and on which products from which countries – remain to be seen. The Trump administration is in the midst of negotiating various trade deals and has yet to release the findings of its investigation into national security implications of drug imports, which is expected to set the stage for tariffs on the industry. In late July, Trump unveiled the framework of a deal with the European Union, which calls for a 15% tariff on pharmaceutical imports – though some generic drugs could be exempt.
Trump had been signaling in recent weeks that he would soon announce drug tariffs of up to 200%, but that he would give drugmakers a year or so to expand their domestic production before the full amount kicks in.
That would be enough time for some companies to expand existing operations, though building new facilities could take three to five years, experts said. Even so, it’s difficult for the manufacturers to make significant longer-term investment decisions amid the uncertainty of both the tariffs and future presidential administrations.
Cost considerations
Increasing their domestic manufacturing will help brand name drug companies escape tariffs, though they may have to pay some levies if they import pharmaceutical ingredients from other countries.
Still, making more drugs in the US doesn’t mean that the products will be any cheaper for patients, experts say.
For one thing, the cost of production is typically higher in the US, said Stephen Farrelly, ING’s global health care sector lead. Plus, the prices that consumers pay are largely governed by the nation’s complex health system, which includes manufacturers, insurers and pharmacy benefit managers, known as PBMs.
So whether Americans get a break on the high cost of their prescriptions will also depend on whether the president can achieve his other initiatives, including bringing US prices more in line with those in Europe and reforming the PBM industry, he said.
While brand name manufacturers have more wiggle room to absorb some of the increased expenses, many experts believe they will pass along at least some of the added burden to consumers – who could eventually feel it in their out-of-pocket cost at the pharmacy counter or in their monthly insurance premiums.
As for generic medicine, shifting more manufacturing to the US would entail higher production costs, which these companies could not afford to cover. Tariffs would be more likely to prompt these drugmakers to pull out of the US market, exacerbating shortages.
“At a time when the administration is clearly looking to still keep the cost down, we don’t see a wholesale redistribution of generic capacity towards the US anytime soon,” Farrelly said.
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