Trump's 100% Pharmaceutical Tariff: Complete List of Drugs Affected (2026)
Effective July 31, 2026, a 100% tariff hits imported branded drugs including Ozempic, Keytruda, Jardiance, and 350+ others. See the full affected drugs list, exemptions, and price impact.
On April 2, 2026, President Trump signed a Presidential Proclamation invoking Section 232 of the Trade Expansion Act to impose a 100% tariff on imported patented (brand-name) pharmaceutical products. The tariff takes effect July 31, 2026 for the 17 largest pharmaceutical companies named in Annex III of the proclamation, and September 29, 2026 for all other importers. This guide breaks down which drugs are affected, which are exempt, and how much more your medication could cost.
Quick Facts: The 100% Pharmaceutical Tariff
| Detail | Value |
|---|---|
| Legal authority | Section 232, Trade Expansion Act (national security) |
| Tariff rate | 100% on wholesale/import value |
| Effective date (Annex III) | July 31, 2026 (17 largest pharma companies) |
| Effective date (others) | September 29, 2026 (all other importers) |
| Products covered | Branded (patented) pharmaceutical products, biologics, and certain APIs under HTS Chapters 29 and 30 |
| Announced | April 2, 2026 |
17 Annex III Pharmaceutical Companies (First Wave — July 31, 2026)
These companies' imported branded drugs face the tariff 60 days earlier than others:
| # | Company | HQ | Key Affected Drugs |
|---|---|---|---|
| 1 | Novo Nordisk | Denmark | Ozempic, Wegovy, NovoLog, Tresiba |
| 2 | Eli Lilly | USA (mostly US-made) | Trulicity, Emgality — exempt; imported specialty drugs affected |
| 3 | Merck | USA | Keytruda (Ireland), Januvia (Singapore), Prevnar 20 |
| 4 | Pfizer | USA | Ibrance (Germany), Xtandi (Japan), Prevnar 20 |
| 5 | AbbVie | USA | Rinvoq (Germany), Skyrizi (Germany), Imbruvica, Vraylar |
| 6 | Johnson & Johnson | USA | Stelara, Xarelto (Germany), Tremfya (Ireland) |
| 7 | Bristol-Myers Squibb | USA | Opdivo (Ireland), Revlimid (Switzerland) |
| 8 | Roche | Switzerland | Xolair, Tecentriq, Hemlibra |
| 9 | Novartis | Switzerland | Entresto, Cosentyx |
| 10 | Sanofi | France | Lantus, Toujeo, Dupixent (via Regeneron) |
| 11 | GSK | UK | Trelegy Ellipta, Nucala, Shingrix (Belgium) |
| 12 | AstraZeneca | UK | Farxiga, Brilinta, Symbicort, Tagrisso |
| 13 | Bayer | Germany | Eylea, Nubeqa, Xofluza |
| 14 | Boehringer Ingelheim | Germany | Jardiance, Spiriva |
| 15 | Takeda | Japan | Entyvio, Trintellix |
| 16 | Regeneron | USA | Dupixent (Ireland-made — affected) |
| 17 | Amgen | USA | Repatha, Otezla, Aimovig (US-made — mostly exempt) |
Which Specific Drugs Are Affected?
The tariff applies based on country of manufacture, not the company's headquarters. Here are the major drugs most likely to face the tariff:
Affected (Imported Brand Drugs)
| Drug | Made In | Current Monthly Retail | Why Affected |
|---|---|---|---|
| Ozempic | Denmark | ~$968 | Novo Nordisk manufacturing in Denmark |
| Wegovy | Denmark | ~$1,349 | Same |
| Keytruda | Ireland | ~$18,000 | Merck manufacturing in Ireland |
| Opdivo | Ireland | ~$15,000 | BMS manufacturing in Ireland |
| Jardiance | Germany | ~$611 | Boehringer Ingelheim in Germany |
| Farxiga | Sweden | ~$610 | AstraZeneca in Sweden |
| Entresto | Switzerland | ~$650 | Novartis in Switzerland |
| Xarelto | Germany | ~$540 | J&J manufacturing in Germany |
| Trelegy Ellipta | UK | ~$680 | GSK in the UK |
| Symbicort | Sweden | ~$380 | AstraZeneca in Sweden |
| Ibrance | Germany | ~$15,500 | Pfizer in Germany |
| Rinvoq | Germany | ~$6,300 | AbbVie in Germany |
| Skyrizi | Germany | ~$11,500 | AbbVie in Germany |
| Stelara | Netherlands | ~$12,500 | J&J in the Netherlands |
| Cosentyx | Switzerland | ~$6,900 | Novartis in Switzerland |
| Xolair | Switzerland | ~$2,850 | Roche in Switzerland |
| Lantus | France | ~$285 | Sanofi in France |
| Vraylar | Hungary | ~$1,650 | AbbVie in Hungary |
| Tagrisso | UK | ~$18,200 | AstraZeneca in the UK |
| Dupixent | Ireland | ~$3,200 | Regeneron/Sanofi in Ireland |
Exempt (US-Manufactured Brand Drugs)
These drugs are made in the United States or Puerto Rico and are exempt:
| Drug | Made In | Why Exempt |
|---|---|---|
| Mounjaro | Indiana, North Carolina | Eli Lilly US manufacturing |
| Zepbound | USA | Eli Lilly US manufacturing |
| Trulicity | USA | Eli Lilly US manufacturing |
| Humira | Puerto Rico | AbbVie US territory manufacturing |
| Enbrel | Puerto Rico | Amgen US territory manufacturing |
| Eliquis | Puerto Rico | BMS US territory manufacturing |
| Repatha | USA | Amgen US manufacturing |
| Otezla | USA | Amgen US manufacturing |
| Biktarvy | USA | Gilead US manufacturing |
| Descovy | USA | Gilead US manufacturing |
| Verzenio | USA | Eli Lilly US manufacturing |
| Taltz | USA | Eli Lilly US manufacturing |
| Emgality | USA | Eli Lilly US manufacturing |
| Aimovig | USA | Amgen US manufacturing |
| Vyvanse | USA | Takeda US manufacturing |
Exempt by Category
Beyond US-made drugs, the proclamation exempts:
- Generic pharmaceuticals — all generic drugs, regardless of manufacturing country
- Biosimilars — cheaper copies of biologics
- Orphan drugs — drugs where all approved indications are orphan-designated
- Nuclear medicines — radiopharmaceuticals
- Plasma-derived therapies — immunoglobulins, clotting factors
- Fertility treatments — IVF medications
- Cell and gene therapies — CAR-T, AAV therapies
- Antibody-drug conjugates — targeted cancer therapies
- Veterinary pharmaceuticals — animal health drugs
How Much More Will Your Medication Cost?
The tariff applies to wholesale/import cost, not retail. Brand pharma wholesale cost is typically 20-35% of retail. Historical industry norms suggest manufacturers pass 25-75% of input cost shocks through to retail prices. Here's the likely impact:
| Scenario | Passthrough | Example: $1,000/mo drug becomes |
|---|---|---|
| Conservative | 25% | $1,300/month (+$300) |
| Likely | 50% | $1,500/month (+$500) |
| Worst case | 100% | $2,000/month (+$1,000) |
For high-cost specialty drugs like Keytruda ($18,000/month today), even a conservative 25% retail impact means +$4,500/month or +$54,000/year.
Use TariffCheck's drug tariff calculator to see the specific projected impact on your medication.
Company Response: The Deal Option
The White House has signaled that pharmaceutical companies can avoid the tariff by signing pricing and onshoring deals — essentially agreeing to:
- Lower list prices for specific drugs in the US market
- Commit to building or expanding US manufacturing
- Accept Most-Favored-Nation (MFN) reference pricing for certain categories (e.g., GLP-1 drugs)
Several companies including Eli Lilly, Pfizer, and Merck have reportedly initiated negotiations. If your drug's manufacturer signs a deal before the effective date, the tariff may not apply — but prices may still change due to the deal terms.
What Patients Should Do Before July 31, 2026
| Action | Benefit | Caveats |
|---|---|---|
| Ask your doctor about generics/biosimilars | Generics are exempt from the tariff | Not all drugs have generics; clinical suitability varies |
| Request a 90-day supply before July 31 | Lock in current pricing | Check insurance rules; don't exceed prescription limits |
| Check if a US-made alternative exists | Mounjaro vs. Ozempic, biosimilar Humira, etc. | Requires doctor's prescription change |
| Talk to your insurance about 2026 formulary changes | Know your new copay tier in advance | Plans update formularies mid-year rarely |
| Apply for patient assistance programs | Manufacturer programs may offset tariff impact | Income and insurance eligibility rules apply |
Will the Tariff Survive Legal Challenge?
Section 232 tariffs have historically been upheld in federal court when the administration cites national security rationale. However, pharmaceutical industry groups (PhRMA, BIO) are expected to challenge the proclamation on the grounds that:
- Pharmaceutical imports do not threaten national security in the traditional sense
- The tariff may violate WTO commitments and trade agreements
- It may conflict with Medicare drug price negotiation law
Legal challenges will take months to resolve. Plan as if the tariff will take effect on schedule.
Frequently Asked Questions
Is my specific drug affected by the tariff?
Search your drug in TariffCheck's drug tariff calculator — we cover 50+ top brand-name drugs with specific exemption status and price impact estimates. The calculator checks based on manufacturing country and exemption category.
If my drug is made in the US, will the price still go up?
US-manufactured drugs are exempt from the tariff itself. However, US-made drugs that compete with imported drugs (e.g., Mounjaro competing with Ozempic) may see demand-driven price increases. Insurance formularies may also shift, changing your copay.
Will my insurance still cover my brand drug?
Insurance coverage itself is unlikely to disappear, but formulary tier, prior authorization requirements, and copay percentage may change. Contact your insurance provider in Q2 2026 to understand how they're preparing for the tariff.
What if I'm on Medicare?
Medicare Part D insulin remains capped at $35/month regardless of tariff. Ten drugs with Medicare-negotiated prices effective January 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, Fiasp/NovoLog) have contractually fixed prices. Conflicts between tariff and negotiation will likely be resolved through administrative action.
Can I buy my drug from Canada to avoid the tariff?
The FDA restricts personal importation of prescription drugs. The agency has historically exercised discretion for 90-day supplies of non-controlled medications for personal use, but this is not guaranteed. The tariff applies at the port of entry — commercial imports are subject to CBP enforcement. Consult a licensed pharmacist before ordering from abroad.
Conclusion
The 100% pharmaceutical tariff effective July 31, 2026 is the biggest change to US drug pricing policy in decades. It will impact 350+ branded drugs, with particularly sharp price effects on specialty medications made in Europe (Ozempic, Keytruda, Jardiance) and Ireland (Opdivo, Stelara, Dupixent). Generics, US-made brands, orphan drugs, and several specialty categories are exempt. Check your specific medication's impact free →