Pharma shipments surge as Trump tariff threat looms

• Imports from Ireland, a manufacturing hub for pharma giants like Pfizer and Johnson & Johnson, not only hit a record in March, but were double the previous high.

"The race is on. Everyone wants to get in before they can't get in anymore," said Marc Busch, an expert in international trade policy from Georgetown University.

• "I'm expecting a lot of disruption and a lot of questions about 'to what end?'," he said of the threat of industry-specific duties. "This is not your typical industry and, in particular, there's going to be a major jolt to the U.S. health care system."

By the numbers: The international trade deficit increased to $140.5 billion in March 2025 from $123.2 billion in February, according to the Commerce Department's Bureau of Economic Analysis and the Census Bureau.

• Virtually all of the $22.5 billion increase in imported consumer goods came from pharmaceutical products.

Between the lines: Imports from Ireland — a major source of cancer drugs, insulin, Viagra and Botox — surged to nearly $31 billion in March.

• That's nearly four times the $8 billion exported in March 2024 and more than double February's imports of $15.3 billion.
• Imports from Denmark — home of Novo Nordisk, which makes blockbuster GLP-1 drugs Ozempic and Wegovy as well as much of the U.S. insulin supply — swelled to $1.2 billion in March 2025 from $810 million in March 2024. That's also up from $825 million in February.

Catch up quick: President Trump has said he expects to make a decision on pharmaceutical tariffs within the next two weeks as part of a strategy to increase domestic manufacturing of medicines.

• The administration announced last month a national security investigation into the effect of pharmaceutical imports.
• The expectation still is that Trump will invoke emergency economic powers in announcing pharmaceutical tariffs, similar to when he announced "reciprocal" tariffs on goods from Europe, Japan and China in April.
• It's hard to understand a national security rationale for tariffs over lifesaving products like branded drugs, upending a long-held World Trade Organization agreement that ensured no tariffs among wealthy countries on drugs, Georgetown's Busch said.
• "That's why this is going to be such a tremendous shock. And not a shock where you pick between Car A and Car B," he said. "This is going to be a shock where a patient may go without a drug because they can't afford it.

Experts warn that consumers will feel the effects either directly in the cost of drugs at the pharmacy counter or in their monthly insurance premiums.

• Payers may respond by cutting certain drugs from their formularies, said Reshma Ramachandran, a health services researcher at Yale School of Medicine.

Reality check: Tariff impacts likely won't hit all at once, because these stockpiles will provide some reprieve, said Michael Grosberg, a pharma expert at Model N.

• Consumers who are insured likely won't feel price increases until the start of their next insurance plan year, he said.

Yes, but: Manufacturers can only stockpile so much.

What to watch: "It's the generic supply chain I'm really concerned about," Ramachandran said, pointing to the already low-margin business that supplies everything from antibiotics, pediatric cancer medications and the "bread and butter drugs used in an emergency room to keep you from dying."

• "There's a huge concern about whether or not this will disincentivize [manufacturers] from selling to the U.S. market and leave consumers with fewer options ... or potentially make drug shortages worse."