Millions of Americans may face higher medical bills due to Donald Trump’s upcoming tariffs on Indian pharmaceuticals. Last week, Indian Commerce Minister Piyush Goyal visited the US unexpectedly to negotiate a trade deal, following Trump’s announcement of tariffs on India starting April 2. These tariffs are in response to India’s duties on American goods. Goyal aims to prevent tax hikes on critical Indian exports like generic drugs. Nearly half of all US medicines originate from India, with Indian generics making up nine out of ten prescriptions in the country, saving billions in healthcare costs annually. In 2022, savings from Indian generics reached $219 billion. Without a trade deal, Trump’s tariffs could render some Indian generics unprofitable, forcing companies to leave parts of the market and worsening existing drug shortages. Yale University’s Dr. Melissa Barber warns that tariffs could exacerbate supply-demand imbalances, impacting uninsured and low-income individuals. Over 60% of US prescriptions for hypertension and mental health issues use Indian-made drugs. Sertraline, a widely prescribed antidepressant, exemplifies American reliance on Indian supplies, often costing half as much as non-Indian alternatives. Public Citizens’ lawyer Peter Maybarduk expresses concern over access to affordable medicines, noting that one in four patients already skip medications due to cost. Trump faces pressure from US hospitals and generic drugmakers over tariffs on Chinese imports. Since taking office, Trump’s tariffs have increased raw material costs for drugs. While big pharma companies like Pfizer and Eli Lily plan to shift some manufacturing to the US, low-value drug economics do not support such moves. Indian drugmakers argue that manufacturing in India is significantly cheaper. Relocating production facilities would be costly and time-consuming. For Indian pharmaceutical companies, the tariff impact could be severe, as the US is their largest revenue source. Indian firms operating on thin margins may pass tariff costs to consumers. CEO of Cipla, Umang Vohra, suggests businesses should not solely base decisions on tariffs, as they may change in four years. — news from BBC.com