Trump’s 100% Drug Tariffs Could Hit Nursing Homes Where It Hurts Most

Washington, D.C. — The Trump administration is preparing to slap a 100% tariff on patented drug imports from pharmaceutical companies that haven’t reached pricing deals with the White House — a move with potentially serious consequences for nursing homes already grappling with medication shortages and pharmacy disruptions.

According to drafts of the executive order obtained by multiple news outlets, patented medications and their active ingredients would be hit with full double-tariff rates for drugmakers operating outside the president’s most-favored-nation framework. The announcement could come as soon as Thursday.

What the Order Would Actually Do

The proposal creates a tiered system based on whether companies have cooperated with the administration’s drug pricing agenda. Drugmakers that have already signed landmark pricing deals with the Department of Health and Human Services — including Eli Lilly, Pfizer, and Novo Nordisk, among more than a dozen others — would be exempt from the tariffs for three years.

Companies currently in negotiations with HHS would also avoid the full levy, at least temporarily. Those that haven’t engaged at all would face the 100% rate immediately.

There’s also a path for manufacturers willing to move production back to the United States: a 20% tariff now, rising to 100% over four years. Generic drugs are entirely excluded from the proposal.

Separate bilateral agreements would apply different rates to imports from the European Union, Japan, South Korea, Switzerland, and the United Kingdom.

Why Nursing Homes Are Watching Closely

Long-term care facilities depend on a steady, affordable supply of branded medications to manage chronic conditions in elderly residents — drugs for dementia, cardiovascular disease, infections, and pain are daily necessities for most patients.

Those supply chains were already strained before this news. A federal drug pricing law is already squeezing the pharmacies that serve nursing homes, forcing some long-term care pharmacies to scale back or exit the market entirely. Adding 100% tariffs on medications not covered by MFN deals could compound those shortages and push per-resident drug costs higher at a time when facilities have little room to absorb new expenses.

Operators also face uncertainty about which specific drugs would be affected. Many of the branded medications widely used in skilled nursing facilities — including anticoagulants, antipsychotics, and antibiotics — are manufactured overseas or rely on active ingredients imported from foreign suppliers.

The Broader Context

This move extends Trump’s aggressive trade posture into healthcare, invoking national security grounds to justify the tariffs under a Commerce Department review of pharmaceutical imports. The Supreme Court struck down the administration’s sweeping global tariffs from 2025, but this pharmaceutical order takes a narrower, sector-specific approach — which legal experts say is more defensible.

The administration has been pushing for U.S.-based drug manufacturing since taking office, and the wave of domestic investment pledges from major drugmakers over the past year was largely driven by the threat of exactly this kind of action.

For nursing homes, the critical question is timing. A facility locked into annual medication contracts can’t reprice mid-year. If the order arrives before operators can negotiate alternative suppliers or shift to generics, some could face sudden cost increases with no easy exit.