Pharmaceutical imports to the United States soared to $50 billion in March 2025, a 20% spike compared to total annual imports in 2024, as drugmakers raced to stockpile medicines ahead of potential tariffs threatened by US President Donald Trump, according to Reuters.
The unprecedented surge, driven by fears of new trade barriers, upended global supply chains and reshaped US trade dynamics, with Ireland emerging as the primary beneficiary. Ireland, the largest exporter of pharmaceuticals to the US, saw its goods imports to America jump by $15.5 billion, with drugs accounting for the majority of the increase.
This propelled Ireland’s trade surplus with the US above China’s for the first time, underscoring its pivotal role in global pharmaproduction. Matthew Martin, a senior economist at Oxford Economics, noted that 20 billion of the $50 billion pharmaceutical import total originated from Ireland alone, highlighting the country’s outsized influence.
Major US drugmakers like Pfizer and Merck have relied heavily on Irish manufacturing hubs. Merck, for instance, accelerated shipments of its cancer drug Keytruda—produced in Ireland—to secure US inventory through 2025. Pfizer similarly ramped up air freight deliveries to bypass potential disruptions, with CEO Albert Bourla stating the company was “increasing inventory each month” to mitigate risks.
As you can imagine, we have done everything that we have to do to make sure that we mitigate, so that includes inventory, of course, and many other things.
The stockpiling follows Trump’s escalating rhetoric against foreign drug dependency. In April 2025, his administration launched a national security probe into pharmaceutical imports, framing reliance on overseas production as a vulnerability. Trump vowed to announce tariffs within weeks, coupled with an executive order to streamline US drug manufacturing regulations, a move critics argue could take years to offset import reliance.
The US imports 60% of its medicines, with generics (90% of prescriptions) largely sourced from India and China. However, branded drugs from Ireland and the EU, such as Novo Nordisk’s Ozempic and Roche’s therapies, dominate by value. A 25% tariff could raise US drug costs by $51 billion annually, with generics manufacturers warning of supply chain collapses and price hikes for critical treatments like antibiotics and chemotherapy drugs.
Broader economic and geopolitical fallout
The pharma surge contributed to a record US trade deficit of $140.5 billion in March, as businesses across sectors rushed to import goods ahead of Trump’s broader “Liberation Day” tariffs. While consumer goods drove the deficit, pharmaceuticals accounted for $20.9 billion of the increase, reflecting sector-specific anxieties.
Ireland faces acute risks, as tariffs could slash its economic growth from 2.5% to 2% in 2025 and cost 25,000 jobs, given its reliance on US multinationals. Swiss and Singaporean exporters are also vulnerable, with Oxford Economics identifying both as high-risk targets for levies.
Pharmaceutical executives warn that tariffs would disproportionately harm US patients. Giovanni Barbella of Sandoz, a leading generics producer, noted that tighter margins could force companies to exit the US market, exacerbating existing drug shortages. Meanwhile, firms like AstraZeneca and Johnson & Johnson are accelerating US investments—$3.5 billion and $55 billion respectively—to localise production, though such shifts are slower for complex biologics.
While stockpiling may cushion short-term blows, long-term price hikes and supply instability loom. For Ireland, the stakes extend beyond pharma: its economy, already facing a consumer sentiment slump, risks cascading damage from trade wars and potential US corporate tax reforms.
