Postscripts Rx
Conversations Beyond the Prescription. Where pharma, HCPs, life science and digital health solutions meets patients—after the script is written. Conversations on digital health, engagement, and real-world impacts that are re-writing the future of patient engagement.
Postscripts Rx
What Happens When Drug Imports Cost 250% More?
A seismic shift may be approaching the pharmaceutical industry with US administration statements suggesting pharmaceutical import tariffs could reach a staggering 250 percent. This isn't just another policy headline – it represents a potential transformation of drug pricing, patient access, and brand performance that demands strategic preparation.
With approximately 80% of active pharmaceutical ingredients in US medications coming from overseas, these tariffs could trigger multiple cascading effects. Research shows even modest price increases significantly impact patient adherence – a 25% price hike leads to a 17% drop in medication compliance. When monthly costs exceed $100, patient sensitivity to out-of-pocket expenses spikes dramatically, potentially driving switches from original medications to domestically produced alternatives perceived as more affordable.
The ripple effects extend throughout healthcare ecosystems. Insurers will likely implement stricter formulary controls and prior authorization requirements, creating access barriers that frustrate both patients and providers. Pharmaceutical companies may rationalize portfolios, quietly sunsetting underperforming drugs and leaving patient populations with diminished support. Retail pharmacies, already dedicating substantial time to insurance issues, will shoulder the burden of explaining price increases and coverage challenges to confused patients.
Digital patient engagement platforms emerge as critical tools in this volatile landscape. These solutions can identify cost barriers early, support patients through complex authorization processes, maintain meaningful engagement even for sunset brands, and reduce administrative burdens on healthcare providers. As some manufacturers shift toward domestic production – potentially delaying launches by years despite regulatory streamlining efforts – digital engagement becomes essential for maintaining therapeutic continuity and brand loyalty.
What's your contingency plan for when these tariffs hit? Share your thoughts with us at postscriptspodcast.com and subscribe to hear from our upcoming guests navigating these uncharted waters.
PostScripts Rx is not intended to constitute medical advice, nor is it intended to influence prescribing decisions or any other medical or clinical decision-making. All medical and clinical judgment and decision-making, prescribing decisions, and all related considerations remain exclusively the responsibility of providers and patients.
Hello and welcome to Postscripts, the podcast exploring what happens after the first prescription. We cover the latest innovations in patient access and support, digital tools, hcp engagement and pharma marketing that drive better outcomes. This podcast is for informational purposes only and does not constitute medical advice or should be used to influence any clinical decision-making. Patients should always consult their healthcare professionals. Welcome to Postscripts. My name is Brian Carr. I work at Medisafe, a platform that's been installed by 13 million people and patients and caregivers worldwide, although my opinions here expressed here are my own and not necessarily those of Medisafe or its partners. Folks, welcome.
Speaker 1:A new pharma landscape could be emerging in front of our eyes here. This week, the US administration actually said tariffs on pharmaceutical imports could reach up to 250 percent in the coming years. This is a headline that grabbed a lot of attention, but let's consider that the ripple effects on the pharma industry may be somewhat profound and long lasting. The tariffs could pose a major disruption to drug pricing, patient access, payer dynamics right and, ultimately, the brand performance. So for many stakeholders in pharma, especially some brand marketers and innovation teams, this could be a tectonic shift that really invites a proactive response. Today we're going to explore some five plausible scenarios on how such 250% tariffs might play out in the rest of this year and into 2026. And how digital patient engagement platforms and innovators and other solutions, including Medisafe, can mitigate risks, sustain adherence and drive stronger ROI in volatile times. So let's see scenario number one. Cost shocks could lead to market disruption and brand switching right. So if import tariffs potentially hit 250%, as was reported on August 5th of 2025 by CNBC and others, any medication manufactured overseas from the US which constitutes roughly 80% of the active pharmaceutical ingredients here in the US, which constitutes roughly 80% of the active pharmaceutical ingredients here in the US, according to the FDA they may see cost increases passed on to healthcare systems and payers and even patients themselves.
Speaker 1:So an HRI report indicated that a 25% increase in drug prices leads to a 17% drop in patient adherence, and I think most people listening to this podcast know. If you drop patient adherence and I think most people listening to this podcast know if you drop patient adherence, some of the outcomes can actually be more expensive as you increase sometimes visits to emergency rooms, et cetera. So in acute care Price Waterhouse, their health research institute, also noted that US patients are already sensitive to the out-of-pocket spikes, especially when monthly costs go over $100. So if you see higher list prices and patient costs driving brand switching, for example, from original medications to domestically produced generics or biosimilars or competitor brands that can be perceived as more affordable For brand marketers, the patient drop-off isn't just a loss in volume, it's a loss in long-term loyalty, data insights, etc. So this is where you know digital solutions and innovators may be able to help with intelligent, customizable platforms that really help patients stay on therapy, feel guided, get them onboarded correctly and get derived. Derive some real-world support with digital devices and platforms so that really could boost therapeutic loyalty.
Speaker 1:Even when cost crunches are there and you know you can identify hey, is cost becoming an issue with certain patients because of the personalized ability of digital platforms and what mitigation measures and interventions can be done for those particular patients. Right, so you're going to see a lot more pressure on prior authorization and payer pressure. Right, so you're going to see a lot more pressure on prior authorization and payer pressure. Right? So if drug import costs are going up, you're going to see insurers likely institute higher formulary controls and even surge prior authorization protocols. Right, so this threatens brand accessibility within the payer ecosystem, especially for those specialty drugs and expensive chronic therapies. So you know, according to the AM ecosystem, especially for those specialty drugs and expensive chronic therapies. So you know, according to the AMA, physicians encounter delays authorization delays in 91% of their prescribing decisions, with patient abandonment nearly 40%, when the authorization timelines go beyond even seven days.
Speaker 1:So pharma teams can really respond with robust digital engagement programs. They keep patients informed, ready, supported, even before they have access to the drug. You know you can get notifications in digital platforms. Yes, your prior authorization is needed. We know in our platform you can actually take a photo of your documentation. You don't have to go to a fax machine to send it off to your PSP support team. To get prior authorization can expedite things significantly and you know it could also get alerts. Here's where you're, here's the stage you're at now and approvals are done. They can be notified. Patients individually have the digital notification and they know they're staying on track. And you know it can be deployed and really nudge patients. Hey, we're still waiting, it's been three days. We need you to upload your prior authorization. You can use reminders that way and really get in contact with patients, as opposed to always trying to call them and they may not be ready to answer the phone for that.
Speaker 1:Let's think of a third scenario here. It could be the rationalization and cuts support for slower moving therapies, right. So as farmers are going to adjust, likely to manufacturing costs and tariffs, you may see a portfolio contraction, consolidation of some brands. Legacy low-performing drugs may be quietly sunset, leaving those existing patient populations with fewer support services or copay programs. You know, if brand teams don't pull back entirely, some digital tools may be able to offer cost-effective ways to keep engagement even in. You know if something's going into a sunset mode, you know you can continue meaningful one-on-one support, tracking adherence, delivering educational content, alerting. You know patients when coverage is about to change, and things like that. You can do that pretty much directly and cost efficiently. If you're sunsetting brands, what are the replacement brands that are going to be recommended? You can contact and let patients know that, for example, this could maintain retention. You know there's even a PR consideration, that of how are we going to contact patients whose brand may be sunset, and with digital tools, you can efficiently say yes, we are we going to contact patients whose brand may be Sunset, and with digital tools, you can efficiently say yes, we are actually going to be staying in touch with patients and giving them the support they need as we transition off this efficiently with digital tools, right?
Speaker 1:So another scenario here you may see some retail pharmacies and HCPs start feeling the strain and that could really disrupt fulfillment, right? So pharmacies and providers they're going to be on the front lines of this, explaining price increases, some of the coverage challenges, right, even formulary changes to some of the patients. So this may strain already limited workflow capacity. So, according to the National Community Pharmacists Association, you know, independent pharmacies spend up to 20% of their hours on insurance issues alone. So that number could actually rise. Without a paperwork for international import disruption or out-of-pocket surges. And pharma teams, you know can lighten the load for HCPs and pharmacists with automated patient onboarding tools, refill alerts, inherent snudges with tools like Medisafe and others, you know, with customizable tool sets that you know deliver pre-approved educational content, messaging and FAQs, reminders and alerts. So really take some time pressure off the frontline stakeholders really delivering supportive content, you know, dynamically, and fulfilling the journey as it evolves from even picking up the prescription to persistence, you know.
Speaker 1:One last scenario here you may see a shift toward domestic drug manufacturing and it could delay launches, right? So some pharma companies are already talking about, they may relocate some manufacturing to the US sites. However, this transition does include usually some regulatory inspections, compliance, full production stand-up typically can take five to 10 years to start a new production facility in the United States and that could delay some drug launches to a year or two. Although I will say one of the under-reported things in the underreported things in the administration's executive order was that it is the administration's responsibility to have agencies such as the FDA and the EPA really streamline approvals for pharma organizations that want to start production facilities in the United States to really increase and hasten the time to market for those facilities to come online. So you may actually see that as a benefit coming out of it. So you know, when you look at the end here we're still in the middle of this.
Speaker 1:You've got five different scenarios that could, some of which could happen, all of which or none of them, we're happy to discuss that at any time. If you want to go to postscriptspodcastcom or send us an email there or contact us in the form there, we'd love to talk about it on the podcast, see what you think about it as well. So, everyone, I want you to have a great day. Thank you so much for coming by and please like and subscribe so you can hear our next one. We've got a lot of guests coming up that you might be really interested in hearing. Have a great day.
