Donald Trump has announced a potential 100% tariff on pharmaceutical companies that do not negotiate deals to lower drug prices in the United States. This tariff will specifically target branded drugs and their active ingredients, while generic drugs, which constitute over 90% of medicines sold in the U.S., will be exempt for at least one year. Exemptions will also apply to orphan, veterinary, and specialty drugs from trade deal countries or those addressing urgent public health needs. Drugmakers that enter pricing agreements with the White House or increase domestic production will avoid these tariffs. Larger companies have 120 days to negotiate, while smaller companies have 180 days. Critics, including the Midsized Biotech Alliance of America (MBAA), have expressed concerns that the policy could create an “unfair two-tiered system” that benefits larger firms, leaving mid-sized drugmakers vulnerable to sudden cost increases. This announcement comes amid rising pressure on the Biden administration to lower drug prices and address the overall cost of living, which Trump attributes to current economic policies. U.S. patients currently pay nearly three times more for prescription medications compared to those in other developed nations.