What Happens When Drug Imports Cost 250% More?

A seismic shift may be approaching the pharmaceutical industry with US administration statements suggesting pharmaceutical import tariffs could reach a staggering 250 percent. This isn't just another policy headline – it represents a potential transformation of drug pricing, patient access, and brand performance that demands strategic preparation.

With approximately 80% of active pharmaceutical ingredients in US medications coming from overseas, these tariffs could trigger multiple cascading effects. Research shows even modest price increases significantly impact patient adherence – a 25% price hike leads to a 17% drop in medication compliance. When monthly costs exceed $100, patient sensitivity to out-of-pocket expenses spikes dramatically, potentially driving switches from original medications to domestically produced alternatives perceived as more affordable.

The ripple effects extend throughout healthcare ecosystems. Insurers will likely implement stricter formulary controls and prior authorization requirements, creating access barriers that frustrate both patients and providers. Pharmaceutical companies may rationalize portfolios, quietly sunsetting underperforming drugs and leaving patient populations with diminished support. Retail pharmacies, already dedicating substantial time to insurance issues, will shoulder the burden of explaining price increases and coverage challenges to confused patients.

Digital patient engagement platforms emerge as critical tools in this volatile landscape. These solutions can identify cost barriers early, support patients through complex authorization processes, maintain meaningful engagement even for sunset brands, and reduce administrative burdens on healthcare providers. As some manufacturers shift toward domestic production – potentially delaying launches by years despite regulatory streamlining efforts – digital engagement becomes essential for maintaining therapeutic continuity and brand loyalty.

What's your contingency plan for when these tariffs hit? Share your thoughts with us at postscriptspodcast.com and subscribe to hear from our upcoming guests navigating these uncharted waters.

PostScripts Rx is not intended to constitute medical advice, nor is it intended to influence prescribing decisions or any other medical or clinical decision-making. All medical and clinical judgment and decision-making, prescribing decisions, and all related considerations remain exclusively the responsibility of providers and patients.

Episode Transcript

Speaker 1 (00:01):
Hello and welcome to Postscripts, the podcast
exploring what happens after thefirst prescription.
We cover the latest innovationsin patient access and support,
digital tools, hcp engagementand pharma marketing that drive
better outcomes.
This podcast is forinformational purposes only and
does not constitute medicaladvice or should be used to
influence any clinicaldecision-making.

(00:21):
Patients should always consulttheir healthcare professionals.
Welcome to Postscripts.
My name is Brian Carr.
I work at Medisafe, a platformthat's been installed by 13
million people and patients andcaregivers worldwide, although
my opinions here expressed hereare my own and not necessarily
those of Medisafe or itspartners.
Folks, welcome.
A new pharma landscape could beemerging in front of our eyes

(00:43):
here.
This week, the USadministration actually said
tariffs on pharmaceuticalimports could reach up to 250
percent in the coming years.
This is a headline that grabbeda lot of attention, but let's
consider that the ripple effectson the pharma industry may be
somewhat profound and longlasting.
The tariffs could pose a majordisruption to drug pricing,

(01:04):
patient access, payer dynamicsright and, ultimately, the brand
performance.
So for many stakeholders inpharma, especially some brand
marketers and innovation teams,this could be a tectonic shift
that really invites a proactiveresponse.
Today we're going to exploresome five plausible scenarios on
how such 250% tariffs mightplay out in the rest of this

(01:27):
year and into 2026.
And how digital patientengagement platforms and
innovators and other solutions,including Medisafe, can mitigate
risks, sustain adherence anddrive stronger ROI in volatile
times.
So let's see scenario numberone.
Cost shocks could lead tomarket disruption and brand

(01:49):
switching right.
So if import tariffspotentially hit 250%, as was
reported on August 5th of 2025by CNBC and others, any
medication manufactured overseasfrom the US which constitutes
roughly 80% of the activepharmaceutical ingredients here
in the US, which constitutesroughly 80% of the active
pharmaceutical ingredients herein the US, according to the FDA

(02:09):
they may see cost increasespassed on to healthcare systems
and payers and even patientsthemselves.
So an HRI report indicated thata 25% increase in drug prices
leads to a 17% drop in patientadherence, and I think most
people listening to this podcastknow.
If you drop patient adherenceand I think most people
listening to this podcast knowif you drop patient adherence,
some of the outcomes canactually be more expensive as
you increase sometimes visits toemergency rooms, et cetera.

(02:33):
So in acute care PriceWaterhouse, their health
research institute, also notedthat US patients are already
sensitive to the out-of-pocketspikes, especially when monthly
costs go over $100.
So if you see higher listprices and patient costs driving
brand switching, for example,from original medications to

(02:53):
domestically produced genericsor biosimilars or competitor
brands that can be perceived asmore affordable For brand
marketers, the patient drop-offisn't just a loss in volume,
it's a loss in long-term loyalty, data insights, etc.
So this is where you knowdigital solutions and innovators
may be able to help withintelligent, customizable

(03:14):
platforms that really helppatients stay on therapy, feel
guided, get them onboardedcorrectly and get derived.
Derive some real-world supportwith digital devices and
platforms so that really couldboost therapeutic loyalty.
Even when cost crunches arethere and you know you can
identify hey, is cost becomingan issue with certain patients

(03:35):
because of the personalizedability of digital platforms and
what mitigation measures andinterventions can be done for
those particular patients.
Right, so you're going to see alot more pressure on prior
authorization and payer pressure.
Right, so you're going to see alot more pressure on prior
authorization and payer pressure.
Right?
So if drug import costs aregoing up, you're going to see
insurers likely institute higherformulary controls and even

(03:57):
surge prior authorizationprotocols.
Right, so this threatens brandaccessibility within the payer
ecosystem, especially for thosespecialty drugs and expensive
chronic therapies.
So you know, according to theAM ecosystem, especially for
those specialty drugs andexpensive chronic therapies.
So you know, according to theAMA, physicians encounter delays
authorization delays in 91% oftheir prescribing decisions,

(04:18):
with patient abandonment nearly40%, when the authorization
timelines go beyond even sevendays.
So pharma teams can reallyrespond with robust digital
engagement programs.
They keep patients informed,ready, supported, even before
they have access to the drug.
You know you can getnotifications in digital

(04:38):
platforms.
Yes, your prior authorizationis needed.
We know in our platform you canactually take a photo of your
documentation.
You don't have to go to a faxmachine to send it off to your
PSP support team.
To get prior authorization canexpedite things significantly
and you know it could also getalerts.
Here's where you're, here's thestage you're at now and
approvals are done.
They can be notified.
Patients individually have thedigital notification and they

(04:59):
know they're staying on track.
And you know it can be deployedand really nudge patients.
Hey, we're still waiting, it'sbeen three days.
We need you to upload yourprior authorization.
You can use reminders that wayand really get in contact with
patients, as opposed to alwaystrying to call them and they may
not be ready to answer thephone for that.
Let's think of a third scenariohere.
It could be the rationalizationand cuts support for slower

(05:23):
moving therapies, right.
So as farmers are going toadjust, likely to manufacturing
costs and tariffs, you may see aportfolio contraction,
consolidation of some brands.
Legacy low-performing drugs maybe quietly sunset, leaving
those existing patientpopulations with fewer support

(05:44):
services or copay programs.
You know, if brand teams don'tpull back entirely, some digital
tools may be able to offercost-effective ways to keep
engagement even in.
You know if something's goinginto a sunset mode, you know you
can continue meaningfulone-on-one support, tracking
adherence, deliveringeducational content, alerting.

(06:04):
You know patients when coverageis about to change, and things
like that.
You can do that pretty muchdirectly and cost efficiently.
If you're sunsetting brands,what are the replacement brands
that are going to be recommended?
You can contact and letpatients know that, for example,
this could maintain retention.
You know there's even a PRconsideration, that of how are

(06:25):
we going to contact patientswhose brand may be sunset, and
with digital tools, you canefficiently say yes, we are we
going to contact patients whosebrand may be Sunset, and with
digital tools, you canefficiently say yes, we are
actually going to be staying intouch with patients and giving
them the support they need as wetransition off this efficiently
with digital tools, right?
So another scenario here you maysee some retail pharmacies and
HCPs start feeling the strainand that could really disrupt

(06:46):
fulfillment, right?
So pharmacies and providersthey're going to be on the front
lines of this, explaining priceincreases, some of the coverage
challenges, right, evenformulary changes to some of the
patients.
So this may strain alreadylimited workflow capacity.
So, according to the NationalCommunity Pharmacists
Association, you know,independent pharmacies spend up
to 20% of their hours oninsurance issues alone.

(07:09):
So that number could actuallyrise.
Without a paperwork forinternational import disruption
or out-of-pocket surges.
And pharma teams, you know canlighten the load for HCPs and
pharmacists with automatedpatient onboarding tools, refill
alerts, inherent snudges withtools like Medisafe and others,
you know, with customizable toolsets that you know deliver

(07:31):
pre-approved educational content, messaging and FAQs, reminders
and alerts.
So really take some timepressure off the frontline
stakeholders really deliveringsupportive content, you know,
dynamically, and fulfilling thejourney as it evolves from even
picking up the prescription topersistence, you know.

(07:51):
One last scenario here you maysee a shift toward domestic drug
manufacturing and it coulddelay launches, right?
So some pharma companies arealready talking about, they may
relocate some manufacturing tothe US sites.
However, this transition doesinclude usually some regulatory
inspections, compliance, fullproduction stand-up typically
can take five to 10 years tostart a new production facility

(08:13):
in the United States and thatcould delay some drug launches
to a year or two.
Although I will say one of theunder-reported things in the
underreported things in theadministration's executive order
was that it is theadministration's responsibility
to have agencies such as the FDAand the EPA really streamline
approvals for pharmaorganizations that want to start

(08:36):
production facilities in theUnited States to really increase
and hasten the time to marketfor those facilities to come
online.
So you may actually see that asa benefit coming out of it.
So you know, when you look atthe end here we're still in the
middle of this.
You've got five differentscenarios that could, some of
which could happen, all of whichor none of them, we're happy to
discuss that at any time.

(08:57):
If you want to go topostscriptspodcastcom or send us
an email there or contact us inthe form there, we'd love to
talk about it on the podcast,see what you think about it as
well.
So, everyone, I want you tohave a great day.
Thank you so much for coming byand please like and subscribe
so you can hear our next one.
We've got a lot of guestscoming up that you might be
really interested in hearing.
Have a great day.