April 21, 2025 • 9 mins
Dr. Michael Koren joins Kevin Geddings to discuss how tariffs could significantly impact pharmaceutical prices. They talk about how barriers to import may affect both prescription and especially over-the-counter medication prices. They move onto the difficulty of starting new drug manufacturing in the US and how clinical trials may provide relief for some patients.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Announcer (00:00):
Welcome to the MedEvidence! Monday Minute Radio
Show hosted by Kevin Geddingsof WSOS St Augustine Radio and
powered by ENCORE Research Group.
Each Monday morning, Dr.
Michael Koren calls in to bringyou the latest medical updates
with insightful discussions.
MedEvidence! is where we helpyou navigate the real truth
behind medical research, withboth a clinical and research
(00:20):
perspective.
So sit back, relax and getready to learn about the Truth
Behind the Data in medicine andhealthcare.
This is MedEvidence!
Kevin Geddings (00:30):
Dr.
Michael Koren, as promised,joining us live on the studio
line.
Dr.
Koren, of course a medicaldoctor, cardiologist, research
scientist also heads up the showat ENCORE Research Group and
they do clinical research,leading-edge clinical research.
Today we thought we would talkabout medicines and how they
could be impacted by all thesetariffs that are buzzing around
Washington, right, Dr.
(00:50):
Koren?
Dr. Michael Koren (00:51):
Yes, yes, you and I were just chatting about
the discussions that we hadaround the holiday table over
the holiday weekend, and I thinka lot of families probably talk
about tariffs and how theymight affect your day-to-day
budget and your life over thecourse of the next several
months to years?
Kevin Geddings (01:07):
Yeah, absolutely .
So it turns out that even itemslike Tylenol that people could
maybe use quite frequently aretied to foreign development
right.
Dr. Michael Koren (01:17):
Yeah, yeah.
So people probably have a sensefor it, but don't know the
magnitude of it that a lot ofthe pharmaceuticals both
prescription pharmaceuticals andover-the-counter
pharmaceuticals come fromoverseas, and there's a lot of
reasons for it.
Some of them, quite frankly,are not great reasons, and I
think the administration istrying to address some of those
(01:37):
issues, but by doing it soquickly it creates a lot of
turmoil.
So, for example, there's a lotof manufacturing of US
pharmaceuticals in the countryof Ireland, which is a country
of only about 5 million people,and literally the US
pharmaceutical industry hirestens of thousands of people in
Ireland because of a tax breakthat they get when they
(01:58):
manufacture in Ireland.
So drugs, for example, Mounjaroare primarily manufactured in
Ireland, or Botox is primarilymanufactured in Ireland.
So I think I read somewherethat 90% of the world's Botox
supply comes from Ireland.
You never know that.
So right now, the tariff onthese drugs is probably similar
(02:19):
to what the overall EU tariff is, which is 20%, but there's a
lot of noise about that going up.
And of course, there's a desireof the administration to bring
some of this manufacturing backto the US, and companies like
Eli Lilly have already announcedthat they're going to do that.
Eli Lilly, for example, hasannounced that they're going to
build four new plants, but thattakes time, Kevin.
You can't build a plant in 90days.
(02:40):
So literally these are thingsthat take years and years, and
years to do.
So we'll see.
There can be a lot ofshort-term displacement and, as
far as the over-the-counterstuff, there's a lot of raw
ingredients for pharmaceuticalsthat come out of China and, as
you know, the current tariff onChina is now 145 percent and may
go up from there.
So this will affect a lot ofother manufacturers who use
(03:02):
these raw ingredients and thensell them to the US market.
So how that plays out is reallyuncertain.
And again, these are thingsthat can't change overnight,
because it takes so much time tocreate a new pharmaceutical
factory.
Kevin Geddings (03:14):
Right.
So how soon will folks feelthat?
In other words, how soon do youthink that people would start
having to pay more for Botox orfor Wegovy, or for even Tylenol?
Dr. Michael Koren (03:26):
I'm not sure.
So what I do know is that, inanticipation of the tariffs,
there was a lot of movement ofproduct right before the tariffs
kicked in.
So hopefully there's a littlebit of supply for the next
several months and I'm going toimagine that consumers are going
to start to see price increasesfor a lot of drugs and
especially for theover-the-counter drugs that
(03:48):
don't have big margins.
There's not a whole lot ofmargin there for the
manufacturers to eat, soprobably over-the-counter stuff
will go up in price over thenext several months.
But of course we don't know howall these negotiations will
turn out in terms of whether ornot we find common ground with
our trading partners and figureout a way of avoiding the worst
of the tariffs.
So it's a real big unknownright now.
(04:09):
But I will say that we're goodin the clinical research
industry for the moment.
It is a priority in terms ofdrug supply.
So we're okay for the moment,but it's going to be an
interesting several months interms of how pharmaceuticals are
affected overall.
Kevin Geddings (04:22):
Right and indeed that is a way for folks to deal
with the tariffs right.
They could participate in aclinical trial and that will
greatly.
They won't have to suffer theimpact of these tariffs and how
they impact pharmaceutical costs.
Dr. Michael Koren (04:35):
Yeah, I don't want to overpromise that
because, again, all of ourstudies are really focused on a
particular niche of health, soit's not going to protect you
against what could happen withall tariffs, but what it does is
definitely keeps you in apretty good place in terms of
that particular question thatwe're addressing.
And two, there's stipends thatpeople get when they participate
(04:57):
in these trials, so you canthink of it that you're getting
some money from thepharmaceutical industry to
offset any impact of theseincreases in drug prices.
So a way to kind of even thescore, if you will.
Kevin Geddings (05:09):
It'll be a way to pay for your $25 bottle of
Tylenol, right yeah?
Dr. Michael Koren (05:13):
Well, hopefully it won't get that bad,
but it could.
Kevin Geddings (05:16):
Yeah, interesting stuff.
Yeah, I think that's.
You know.
We always think about cars,right, Dr.
Koren?
We think about TVs or iPhones,and we think about tariffs and
foreign products.
We don't really think about themedications that we take.
Dr. Michael Koren (05:27):
No, it's a huge, huge industry and it
actually affects a lot ofoverseas places in ways you
can't imagine.
So, for example, everybodyknows about Ozempic.
Ozempic is manufactured by NovoNordisk out of Denmark.
Denmark's a country with likemaybe five or six million people
and Novo Nordisk actuallyemploys hundreds of thousands of
(05:50):
people in Denmark.
It's by far the biggestemployer and most of their
products go to the US, quitefrankly, because it's the most
lucrative drug market, so peopleare scared there.
Novo Nordisk stock was the mostvaluable stock in Europe for a
couple of years now and that hassince changed because of
concerns about the tariffs andthe impact on the US trade and
(06:12):
how that's going to affect theUS consumer.
Kevin Geddings (06:14):
Right.
Is there a class of medicationsthat we're pretty good at
making here in the United States?
Dr. Michael Koren (06:20):
Well, we can make anything, and these are, in
many cases, us companies.
Novo Nordisk is not, but EliLilly is, Pfizer is, and so the
know how is there, its just thatbuilding the factory is a huge
undertaking.
And it takes time and they'renot set up.
But, keep in mind that thesecompanies were doing this to
avoid paying taxes, quitefrankly.
And, as long as they book theirprofits overseas and didn't
bring them back home.
They didn't have to pay taxeson those sums of money, and so
(06:51):
that could affect stock pricesfor the pharmaceuticals, for
example, if all of a suddenthey're getting taxed on these
profits immediately rather thanin a deferred way.
So it's a pretty complicatedsituation, but hopefully we'll
find the light of day and comeup with a solution that's not so
onerous.
Kevin Geddings (07:07):
That's Dr.
Michael Koren once again.
By the way, since I have thedoctor here, we should mention
that there's a big Lunch andLearn taking place on Friday
dealing with migraines If youknow someone or you are dealing
with migraine headaches.
The Lunch and Learn will be atWJCT Studios, public radio
studios, right across from wherethe Jaguars play.
This Friday free lunch getsunderway at 11:30.
(07:29):
We'll wrap up at one o'clock,right, doctor?
Dr. Michael Koren (07:31):
Yeah, it's really fascinating.
Dr.
Steven Toenjes is my colleagueand a neurologist fabulous
neurologist, incredibly smart,really very knowledgeable in
migraines and I've learned a lotfrom him over the years on how
to deal with headache issues.
So I think if you have thisproblem or you have a family
member that has this problem, itbehooves you to check it out
(07:51):
and learn more about migrainesand the different solutions that
are available.
Kevin Geddings (07:54):
Yeah, that event is made possible, of course, by
MedEvidence! as well, which isa great platform.
It doesn't cost you anything toget on there, MedEvidence.
com, where you can get some goodinformation not only about
migraines, but thousands ofother health-related topics.
Right, doctor?
Dr. Michael Koren (08:09):
Yeah, yeah.
So we're just getting more andmore excited about MedEvidence!
Again at the holiday tablethere's a lot of discussions
about some of our recentpodcasts with Jerome Adams, the
former Surgeon General, and withTony Fauci.
And check it out, I thinkyou'll find it interesting, and
we cover lots of differenttopics in a very pragmatic way.
Kevin Geddings (08:28):
Yeah,MedE vidence.
com, that's MedEvidence.
com.
You need to sign up if you canRegister for that Migraine Talk,
the Lunch and Learn.
That's this Friday up inJacksonville, and all you have
to do is just go to wjct.
org, just click on the eventsdrop down tab and it's right
there, Dr.
Koren, we appreciate your time.
Thank you very much.
We hope you have a good day.
Dr. Michael Koren (08:47):
I appreciate it, always a pleasure, Kevin.
Announcer (08:49):
Thanks for joining the MedEvidence! podcast.
To learn more, head over toMedEvidence.
com or subscribe to our podcaston your favorite podcast
platform.
Welcome to the MedEvidence! Monday Minute Radio
Show hosted by Kevin Geddingsof WSOS St Augustine Radio and
powered by ENCORE Research Group.
Each Monday morning, Dr.
Michael Koren calls in to bringyou the latest medical updates
with insightful discussions.
MedEvidence! is where we helpyou navigate the real truth
behind medical research, withboth a clinical and research
(00:20):
perspective.
So sit back, relax and getready to learn about the Truth
Behind the Data in medicine andhealthcare.
This is MedEvidence!
Kevin Geddings (00:30):
Dr.
Michael Koren, as promised,joining us live on the studio
line.
Dr.
Koren, of course a medicaldoctor, cardiologist, research
scientist also heads up the showat ENCORE Research Group and
they do clinical research,leading-edge clinical research.
Today we thought we would talkabout medicines and how they
could be impacted by all thesetariffs that are buzzing around
Washington, right, Dr.
(00:50):
Koren?
Dr. Michael Koren (00:51):
Yes, yes, you and I were just chatting about
the discussions that we hadaround the holiday table over
the holiday weekend, and I thinka lot of families probably talk
about tariffs and how theymight affect your day-to-day
budget and your life over thecourse of the next several
months to years?
Kevin Geddings (01:07):
Yeah, absolutely .
So it turns out that even itemslike Tylenol that people could
maybe use quite frequently aretied to foreign development
right.
Dr. Michael Koren (01:17):
Yeah, yeah.
So people probably have a sensefor it, but don't know the
magnitude of it that a lot ofthe pharmaceuticals both
prescription pharmaceuticals andover-the-counter
pharmaceuticals come fromoverseas, and there's a lot of
reasons for it.
Some of them, quite frankly,are not great reasons, and I
think the administration istrying to address some of those
(01:37):
issues, but by doing it soquickly it creates a lot of
turmoil.
So, for example, there's a lotof manufacturing of US
pharmaceuticals in the countryof Ireland, which is a country
of only about 5 million people,and literally the US
pharmaceutical industry hirestens of thousands of people in
Ireland because of a tax breakthat they get when they
(01:58):
manufacture in Ireland.
So drugs, for example, Mounjaroare primarily manufactured in
Ireland, or Botox is primarilymanufactured in Ireland.
So I think I read somewherethat 90% of the world's Botox
supply comes from Ireland.
You never know that.
So right now, the tariff onthese drugs is probably similar
(02:19):
to what the overall EU tariff is, which is 20%, but there's a
lot of noise about that going up.
And of course, there's a desireof the administration to bring
some of this manufacturing backto the US, and companies like
Eli Lilly have already announcedthat they're going to do that.
Eli Lilly, for example, hasannounced that they're going to
build four new plants, but thattakes time, Kevin.
You can't build a plant in 90days.
(02:40):
So literally these are thingsthat take years and years, and
years to do.
So we'll see.
There can be a lot ofshort-term displacement and, as
far as the over-the-counterstuff, there's a lot of raw
ingredients for pharmaceuticalsthat come out of China and, as
you know, the current tariff onChina is now 145 percent and may
go up from there.
So this will affect a lot ofother manufacturers who use
(03:02):
these raw ingredients and thensell them to the US market.
So how that plays out is reallyuncertain.
And again, these are thingsthat can't change overnight,
because it takes so much time tocreate a new pharmaceutical
factory.
Kevin Geddings (03:14):
Right.
So how soon will folks feelthat?
In other words, how soon do youthink that people would start
having to pay more for Botox orfor Wegovy, or for even Tylenol?
Dr. Michael Koren (03:26):
I'm not sure.
So what I do know is that, inanticipation of the tariffs,
there was a lot of movement ofproduct right before the tariffs
kicked in.
So hopefully there's a littlebit of supply for the next
several months and I'm going toimagine that consumers are going
to start to see price increasesfor a lot of drugs and
especially for theover-the-counter drugs that
(03:48):
don't have big margins.
There's not a whole lot ofmargin there for the
manufacturers to eat, soprobably over-the-counter stuff
will go up in price over thenext several months.
But of course we don't know howall these negotiations will
turn out in terms of whether ornot we find common ground with
our trading partners and figureout a way of avoiding the worst
of the tariffs.
So it's a real big unknownright now.
(04:09):
But I will say that we're goodin the clinical research
industry for the moment.
It is a priority in terms ofdrug supply.
So we're okay for the moment,but it's going to be an
interesting several months interms of how pharmaceuticals are
affected overall.
Kevin Geddings (04:22):
Right and indeed that is a way for folks to deal
with the tariffs right.
They could participate in aclinical trial and that will
greatly.
They won't have to suffer theimpact of these tariffs and how
they impact pharmaceutical costs.
Dr. Michael Koren (04:35):
Yeah, I don't want to overpromise that
because, again, all of ourstudies are really focused on a
particular niche of health, soit's not going to protect you
against what could happen withall tariffs, but what it does is
definitely keeps you in apretty good place in terms of
that particular question thatwe're addressing.
And two, there's stipends thatpeople get when they participate
(04:57):
in these trials, so you canthink of it that you're getting
some money from thepharmaceutical industry to
offset any impact of theseincreases in drug prices.
So a way to kind of even thescore, if you will.
Kevin Geddings (05:09):
It'll be a way to pay for your $25 bottle of
Tylenol, right yeah?
Dr. Michael Koren (05:13):
Well, hopefully it won't get that bad,
but it could.
Kevin Geddings (05:16):
Yeah, interesting stuff.
Yeah, I think that's.
You know.
We always think about cars,right, Dr.
Koren?
We think about TVs or iPhones,and we think about tariffs and
foreign products.
We don't really think about themedications that we take.
Dr. Michael Koren (05:27):
No, it's a huge, huge industry and it
actually affects a lot ofoverseas places in ways you
can't imagine.
So, for example, everybodyknows about Ozempic.
Ozempic is manufactured by NovoNordisk out of Denmark.
Denmark's a country with likemaybe five or six million people
and Novo Nordisk actuallyemploys hundreds of thousands of
(05:50):
people in Denmark.
It's by far the biggestemployer and most of their
products go to the US, quitefrankly, because it's the most
lucrative drug market, so peopleare scared there.
Novo Nordisk stock was the mostvaluable stock in Europe for a
couple of years now and that hassince changed because of
concerns about the tariffs andthe impact on the US trade and
(06:12):
how that's going to affect theUS consumer.
Kevin Geddings (06:14):
Right.
Is there a class of medicationsthat we're pretty good at
making here in the United States?
Dr. Michael Koren (06:20):
Well, we can make anything, and these are, in
many cases, us companies.
Novo Nordisk is not, but EliLilly is, Pfizer is, and so the
know how is there, its just thatbuilding the factory is a huge
undertaking.
And it takes time and they'renot set up.
But, keep in mind that thesecompanies were doing this to
avoid paying taxes, quitefrankly.
And, as long as they book theirprofits overseas and didn't
bring them back home.
They didn't have to pay taxeson those sums of money, and so
(06:51):
that could affect stock pricesfor the pharmaceuticals, for
example, if all of a suddenthey're getting taxed on these
profits immediately rather thanin a deferred way.
So it's a pretty complicatedsituation, but hopefully we'll
find the light of day and comeup with a solution that's not so
onerous.
Kevin Geddings (07:07):
That's Dr.
Michael Koren once again.
By the way, since I have thedoctor here, we should mention
that there's a big Lunch andLearn taking place on Friday
dealing with migraines If youknow someone or you are dealing
with migraine headaches.
The Lunch and Learn will be atWJCT Studios, public radio
studios, right across from wherethe Jaguars play.
This Friday free lunch getsunderway at 11:30.
(07:29):
We'll wrap up at one o'clock,right, doctor?
Dr. Michael Koren (07:31):
Yeah, it's really fascinating.
Dr.
Steven Toenjes is my colleagueand a neurologist fabulous
neurologist, incredibly smart,really very knowledgeable in
migraines and I've learned a lotfrom him over the years on how
to deal with headache issues.
So I think if you have thisproblem or you have a family
member that has this problem, itbehooves you to check it out
(07:51):
and learn more about migrainesand the different solutions that
are available.
Kevin Geddings (07:54):
Yeah, that event is made possible, of course, by
MedEvidence! as well, which isa great platform.
It doesn't cost you anything toget on there, MedEvidence.
com, where you can get some goodinformation not only about
migraines, but thousands ofother health-related topics.
Right, doctor?
Dr. Michael Koren (08:09):
Yeah, yeah.
So we're just getting more andmore excited about MedEvidence!
Again at the holiday tablethere's a lot of discussions
about some of our recentpodcasts with Jerome Adams, the
former Surgeon General, and withTony Fauci.
And check it out, I thinkyou'll find it interesting, and
we cover lots of differenttopics in a very pragmatic way.
Kevin Geddings (08:28):
Yeah,MedE vidence.
com, that's MedEvidence.
com.
You need to sign up if you canRegister for that Migraine Talk,
the Lunch and Learn.
That's this Friday up inJacksonville, and all you have
to do is just go to wjct.
org, just click on the eventsdrop down tab and it's right
there, Dr.
Koren, we appreciate your time.
Thank you very much.
We hope you have a good day.
Dr. Michael Koren (08:47):
I appreciate it, always a pleasure, Kevin.
Announcer (08:49):
Thanks for joining the MedEvidence! podcast.
To learn more, head over toMedEvidence.
com or subscribe to our podcaston your favorite podcast
platform.
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