Which Drugs Are Exempt From the 2026 Pharmaceutical Tariff? Full List
Not every drug gets hit by the 100% tariff. US-made drugs, generics, orphan drugs, and specific categories are exempt. See the complete exempt drugs list with examples.
The 100% pharmaceutical tariff announced April 2, 2026 sounds terrifying — but not every drug gets hit. The Presidential Proclamation includes significant exemptions, and millions of patients will see zero tariff impact on their medication. This guide breaks down exactly which drugs are exempt, why, and what that means for your out-of-pocket costs.
Quick Answer: Exempt Categories
The following drug categories are exempt from the 100% pharmaceutical tariff:
| Exemption Category | Why | Example Drugs |
|---|---|---|
| US-manufactured brand drugs | Tariff only applies to imports | Mounjaro, Humira, Eliquis, Enbrel, Biktarvy |
| All generic pharmaceuticals | Generics explicitly excluded | Metformin, simvastatin, atorvastatin, losartan |
| Biosimilars | Biosimilars explicitly excluded | Biosimilar Humira (multiple brands), biosimilar Enbrel |
| Orphan drugs | All-orphan indication drugs excluded | Ultragenyx rare disease drugs, Vertex CF drugs |
| Nuclear medicines | Radiopharmaceuticals excluded | Tc-99m, Lutathera, Pluvicto |
| Plasma-derived therapies | Blood products excluded | Immune globulin, clotting factors, albumin |
| Fertility treatments | IVF meds excluded | Gonal-F, Follistim, Menopur |
| Cell and gene therapies | CAR-T and AAV excluded | Kymriah, Yescarta, Luxturna, Zolgensma |
| Antibody-drug conjugates | ADCs excluded | Kadcyla, Enhertu, Padcev, Trodelvy |
| Veterinary pharmaceuticals | Animal drugs excluded | Apoquel, Cytopoint, Bravecto |
US-Manufactured Brand Drugs (Exempt)
The tariff applies based on country of manufacture, not company headquarters. Many US-headquartered companies manufacture their drugs in the US or Puerto Rico (a US territory):
Eli Lilly (mostly US-made)
| Drug | Indication | Manufacturing |
|---|---|---|
| Mounjaro | Type 2 diabetes | Indianapolis, IN + Durham, NC |
| Zepbound | Weight management | Same as Mounjaro |
| Trulicity | Type 2 diabetes | Indianapolis, IN |
| Verzenio | Breast cancer | US |
| Taltz | Psoriasis | US |
| Emgality | Migraine | US |
| Olumiant | Rheumatoid arthritis | US |
Amgen (US/Puerto Rico)
| Drug | Indication | Manufacturing |
|---|---|---|
| Enbrel | Rheumatoid arthritis, psoriasis | Puerto Rico |
| Repatha | High cholesterol | Thousand Oaks, CA |
| Otezla | Psoriasis | US |
| Aimovig | Migraine | US |
| Prolia/Xgeva | Osteoporosis | US |
AbbVie (Puerto Rico for Humira)
| Drug | Indication | Manufacturing |
|---|---|---|
| Humira | Autoimmune conditions | Puerto Rico |
Note: AbbVie's other major drugs (Rinvoq, Skyrizi, Vraylar) are manufactured in Germany/Hungary and are affected by the tariff.
BMS (Puerto Rico for Eliquis)
| Drug | Indication | Manufacturing |
|---|---|---|
| Eliquis | Blood thinner | Puerto Rico |
Gilead (all US)
| Drug | Indication | Manufacturing |
|---|---|---|
| Biktarvy | HIV | US |
| Descovy | HIV/PrEP | US |
| Truvada | HIV/PrEP | US |
| Veklury (remdesivir) | Antiviral | US |
Takeda (Vyvanse is US)
| Drug | Indication | Manufacturing |
|---|---|---|
| Vyvanse | ADHD | US |
Generic Drugs: The Biggest Exempt Category
Every generic pharmaceutical is exempt, regardless of where it's manufactured. Generic drugs already make up over 90% of US prescriptions by volume.
Top Generic Exempt Drugs
| Generic Name | Treats | Brand Equivalent (may be affected) |
|---|---|---|
| Metformin | Type 2 diabetes | (no brand premium) |
| Atorvastatin | High cholesterol | Lipitor (generic) |
| Simvastatin | High cholesterol | Zocor (generic) |
| Lisinopril | Blood pressure | (no brand premium) |
| Amlodipine | Blood pressure | Norvasc (generic) |
| Omeprazole | Acid reflux | Prilosec (OTC + Rx) |
| Losartan | Blood pressure | Cozaar (generic) |
| Gabapentin | Nerve pain, seizures | Neurontin (generic) |
| Sertraline | Depression | Zoloft (generic) |
| Fluoxetine | Depression | Prozac (generic) |
| Escitalopram | Depression | Lexapro (generic) |
| Levothyroxine | Hypothyroidism | Synthroid (still branded) |
| Bupropion | Depression, smoking cessation | Wellbutrin (generic) |
| Duloxetine | Depression, pain | Cymbalta (generic) |
| Venlafaxine | Depression, anxiety | Effexor (generic) |
| Pantoprazole | Acid reflux | Protonix (generic) |
| Rosuvastatin | High cholesterol | Crestor (generic) |
| Clopidogrel | Blood thinner | Plavix (generic) |
| Hydrochlorothiazide | Blood pressure | (no brand premium) |
| Metoprolol | Heart conditions | Toprol XL (generic) |
Generics Launching in 2026 (Become Exempt Alternatives)
| Brand | Generic | Expected Launch |
|---|---|---|
| Januvia | Sitagliptin | May 2026 |
| Janumet | Sitagliptin/Metformin | May 2026 |
| Xifaxan | Rifaximin | Later 2026 |
| Symbicort | Budesonide/Formoterol (Wixela Inhub) | Already available |
| Advair Diskus | Fluticasone/Salmeterol (Wixela Inhub) | Already available |
Ask your pharmacist about generic substitution — it can be automatic in most states unless your doctor marked "DAW" (Dispense As Written).
Biosimilars: Biologic Generics (Exempt)
Biosimilars are FDA-approved near-copies of biologic drugs (large-molecule drugs made from living cells). They're explicitly exempt from the tariff.
Major Biosimilar Categories
| Reference Drug (often affected) | Biosimilars (exempt) |
|---|---|
| Humira (exempt itself — US-made) | Amjevita, Cyltezo, Hadlima, Hulio, Yuflyma, Yusimry, Hyrimoz |
| Enbrel (exempt itself — US-made) | Erelzi, Eticovo |
| Remicade | Inflectra, Renflexis, Avsola |
| Neulasta | Fulphila, Udenyca, Ziextenzo, Nyvepria, Stimufend |
| Neupogen | Nivestym, Zarxio, Releuko |
| Lantus (affected) | Semglee, Rezvoglar |
| Herceptin | Trazimera, Ogivri, Herzuma, Kanjinti, Ontruzant |
| Avastin | Mvasi, Zirabev, Alymsys, Vegzelma |
| Rituxan | Truxima, Ruxience, Riabni |
Orphan Drugs (Exempt)
An orphan drug is one developed to treat a rare disease (affecting fewer than 200,000 people in the US). If all of a drug's approved indications are orphan-designated, it's exempt from the tariff.
Examples of Orphan-Only Drugs
| Drug | Condition | Manufacturer |
|---|---|---|
| Strensiq | Hypophosphatasia | Alexion |
| Kalydeco | Cystic fibrosis (specific mutations) | Vertex |
| Trikafta | Cystic fibrosis | Vertex |
| Spinraza | Spinal muscular atrophy | Biogen |
| Tegsedi | Hereditary transthyretin amyloidosis | Akcea |
| Amondys 45 | Duchenne muscular dystrophy | Sarepta |
| Evrysdi | Spinal muscular atrophy | Genentech/Roche |
Important caveat: If a drug has both orphan and non-orphan indications, it may not qualify for the orphan exemption. Keytruda, for example, has orphan designation for some cancers but many non-orphan indications — so it's not exempt.
Cell and Gene Therapies (Exempt)
These are some of the most expensive therapies in medicine — but they're exempt from the tariff.
Approved Cell/Gene Therapies
| Drug | Treats | Approximate Cost |
|---|---|---|
| Kymriah | Leukemia, lymphoma | $475,000 one-time |
| Yescarta | Lymphoma | $373,000 one-time |
| Tecartus | Lymphoma | $373,000 one-time |
| Breyanzi | Lymphoma | $410,300 one-time |
| Abecma | Multiple myeloma | $419,500 one-time |
| Carvykti | Multiple myeloma | $465,000 one-time |
| Luxturna | Inherited retinal disease | $425,000 per eye |
| Zolgensma | Spinal muscular atrophy | $2.1M one-time |
| Casgevy | Sickle cell disease | $2.2M one-time |
| Hemgenix | Hemophilia B | $3.5M one-time |
Their exemption reflects the policy view that these one-time curative therapies are strategically different from chronic medications.
Fertility Treatments (Exempt)
IVF medications are specifically exempt:
| Drug | Indication |
|---|---|
| Gonal-F | Ovulation induction |
| Follistim | Ovulation induction |
| Menopur | Ovulation induction |
| Cetrotide | Prevent premature ovulation |
| Ganirelix | Prevent premature ovulation |
| Pregnyl | Trigger ovulation |
| Ovidrel | Trigger ovulation |
| Lupron | IVF protocol |
| Crinone | Progesterone support |
| Endometrin | Progesterone support |
If you're going through IVF, your medication costs should not change due to the tariff.
Drugs With Likely Company Deals (Possibly Exempt)
Several pharma companies are negotiating pricing/onshoring deals with the administration. If a company signs a deal, their drugs may be exempted.
Companies known to be in negotiations:
- Eli Lilly — already US-made for most blockbusters
- Pfizer — discussing onshoring commitments
- Merck — discussing GLP-1 and oncology deals
- Bristol-Myers Squibb — discussing Eliquis (already Puerto Rico-made) + onshoring
- Novo Nordisk — discussing Ozempic/Wegovy MFN pricing
- AstraZeneca — discussing broader portfolio
- GSK — discussing vaccines
If your drug's manufacturer signs a deal before July 31, 2026 or September 29, 2026 (depending on Annex III status), the tariff may not apply.
How to Check If YOUR Drug Is Exempt
- Search the calculator: TariffCheck's drug tariff tool lists exemption status for 50+ top brand drugs
- Check the pill bottle: Look for "Manufactured by X in [country]" — if the country is the US or Puerto Rico, you're exempt
- Ask your pharmacist: They have access to the National Drug Code (NDC) directory which lists manufacturing site
- Check the FDA label: Available at dailymed.nlm.nih.gov — "HOW SUPPLIED" section typically lists manufacturing location
Frequently Asked Questions
My doctor says my drug is generic but it has a brand name on the bottle. Is it affected?
No. Generics are exempt regardless of how they're marketed. Many generics carry "authorized generic" branding, which is still a generic. Any drug with a lowercase generic name on the label (e.g., "sitagliptin 100 mg" vs "Januvia 100 mg") is exempt.
What if my insurance only covers the brand but not the generic?
Talk to your doctor about switching — most state pharmacy laws allow substitution unless the prescription says "DAW." If your insurer has excluded the generic from coverage, you may want to pay out-of-pocket for the generic (often cheaper than the brand copay anyway).
Are supplements and OTC drugs affected?
Over-the-counter (OTC) drugs and dietary supplements are not covered by the Section 232 pharmaceutical tariff, but they may be subject to other tariffs (e.g., Section 301 if made in China) under the standard tariff system. See our main tariff calculator for non-pharmaceutical products.
Is Puerto Rico really considered US for this tariff?
Yes. Puerto Rico is a US territory, and drugs manufactured there are treated as US-made for customs purposes. This is why AbbVie (Humira), BMS (Eliquis), and Amgen (Enbrel) are largely exempt despite being major international pharma companies.
What if my drug is partially made abroad?
This is called "substantial transformation" and CBP uses specific rules to determine country of origin. Generally, if the final formulation and fill happens in the US, the drug is considered US-origin. But this can be complex — check the FDA label or ask the manufacturer.
Conclusion
The 100% pharmaceutical tariff is broad but not universal. US-made brand drugs (Mounjaro, Humira, Eliquis, Enbrel, Biktarvy, many more), all generics and biosimilars, orphan drugs, cell and gene therapies, fertility meds, and several specialty categories are exempt. If you're worried about your specific medication, check its exemption status here — many patients will discover their drug is unaffected.