Pharma tariffs could increase US drug costs by $51B a year, report finds

A 25% tariff on pharmaceutical imports to the United States could increase national drug costs by almost $51 billion a year, according to an Ernst & Young report reviewed by Reuters.

The report, which was not made public and commissioned by the Pharmaceutical Research and Manufacturers of America, found that the United States imported $203 billion in pharmaceutical products in 2023, with 73% of them coming from Europe. Total U.S. sales of finished pharmaceuticals in 2023 were $393 billion.

The report also found that around 30% of pharmaceutical imports in 2023 were ingredients used in U.S. manufacturing and then exported or sold in the United States. Tariffs on these products would increase domestic production costs by 4.1% and reduce the global competitiveness of U.S.-made drugs, the report said.

To date, pharmaceuticals have been spared from the tariffs implemented by the Trump administration. However, President Donald Trump has repeatedly threatened a 25% tariff on pharmaceutical imports, and last week the administration announced probes into pharmaceutical imports.

(Fick, Reuters, 4/25)

Trump says he'd veto any cuts to Medicaid

President Donald Trump in an interview with TIME magazine said that he would not sign any legislation that calls for cuts to Medicaid, Medicare, or Social Security. "If it cuts it, I would not approve," he said.

"I would veto it, yeah. But they're not going to do that," he added, saying he's open to measures that reduce "waste, fraud, and abuse" in Medicaid.

Currently, Republicans in Congress are debating cuts to Medicaid as they look for spending reductions to offset a tax bill, and lawmakers have yet to agree on the scope of the spending cuts they'll pursue. Republicans must find $4 billion worth of spending cuts to meet the parameters of a budget outline passed earlier this month.

House Speaker Mike Johnson (R-La.) has set a target of the end of May to enact the tax bill. However, Senate Republicans have talked about completing the process by August.

(Lowenkron, Bloomberg/Modern Healthcare, 4/25)

The order also said that ACGME "'expect[s]' institutions to focus on implementing 'policies and procedures related to recruitment and retention of individuals underrepresented in medicine' including 'racial and ethnic minority individuals.'"

"The standards for training tomorrow's doctors should focus solely on providing the highest quality care, and certainly not on requiring unlawful discrimination," the order continued.

The order states that the Secretary of Education shall "resume recognizing new accreditors to increase competition and accountability in promoting high-quality, high-value academic programs focused on student outcomes."

In response, LCME said it will "work with the administration to provide requested information and to provide evidence of our ongoing commitment to outcomes-based evaluations of medical education program quality with the goal of producing outstanding physicians."

ACGME said it takes the order "very seriously" and is evaluating "its implications for our standards."

"Our mission is to improve healthcare and population health by assessing and enhancing the quality of resident and fellow physicians' education through advancements in accreditation and education, and we strive to prepare physicians to provide patients with the highest quality care possible through the education they receive," ACGME said.

(Clark, MedPage Today, 4/25)

NIH announces registry of people with autism, HHS walks back plan

NIH Director Jay Bhattacharya last week announced that the agency would create "national disease registries, including a new one for autism" that would accelerate research into the rapid increase of autism diagnoses in the United States.

The new data would allow external researchers picked for HHS Secretary Robert F. Kennedy Jr.'s study on autism rates in the United States to study "comprehensive" patient data with "broad coverage" of the U.S. population for the first time, Bhattacharya added.

According to Bhattacharya, medication records from pharmacy chains, lab testing and genomics data from patients treated by the Department of Veterans Affairs and Indian Health Service, claims from private insurers, and data from smartwatches and fitness trackers would all be linked together.

The announcement sparked backlash over potential privacy violations, lack of consent, and the risk of long-term misuse of the data.

The Autism Self Advocacy Network noted the vagueness of the plan, especially whether the data would contain "personally identifying information" or whether people will have the opportunity to opt out of the collection of personal data.

"I don't think that a registry is inherently bad," said David Mandell, a psychiatrist and director of the University of Pennsylvania Center for Mental Health. "It can help us identify points of onset, points for intervention, treatments that seem to be helpful, services and supports that seem to result in better quality of life. It's great for those questions. It's just, those aren't the questions that Kennedy is talking about answering."

This backlash led HHS to announce that it will no longer create a registry of Americans with autism and will instead launch a $50 million research effort to understand the causes of autism spectrum disorder and improve treatments.

(Cha et. al., Washington Post, 4/25; Tin, CBS News, 4/22; Lalljee/Rychlewski, Axios, 4/23; Broderick, STAT+ [subscription required], 4/24)

FDA commissioner says there are no plans to restrict abortion pill access

FDA Commissioner Marty Makary said during the Semafor World Economy Summit last week that he has no plans to change current policy regarding access to the abortion pill mifepristone, though he added he would reconsider if there is new data that would suggest a safety issue.

FDA approved mifepristone in 2000 to terminate pregnancies up to seven weeks, and scientists and top medical groups contend it has been studied extensively and is proven to be safe.

In April 2023, Judge Matthew Kacsmaryk issued a ruling invalidating FDA's approval of mifepristone, arguing that the agency didn't adequately review scientific evidence or follow the proper protocols when it approved the drug.

In June 2024, the Supreme Court unanimously rejected a challenge to mifepristone, finding that the group of anti-abortion doctors challenging FDA's decision on the drug lacked legal standing. However, several states are continuing to challenge FDA rules that expanded access to the pill.

For his part, President Donald Trump said he had been "against stopping" mifepristone during his presidential campaign and that it was "very unlikely" he would restrict access, adding that his "commitment" would be to ensure FDA didn't strip access to the drug.

(Weixel, The Hill, 4/25)