U.S. policy makers escalated tariff pressure on imported branded drugs, but carveouts and “most-favored nation” agreements are shaping the near-term impact. Trump signed an executive order imposing 100% ad valorem duties on patented pharmaceuticals and associated ingredients, while exempting generics, orphan drugs and branded products tied to Most Favored Nation agreements. The order also sets a reduced tariff path for companies that pledge to start manufacturing in the U.S., creating a high-stakes negotiation window for pricing and supply-chain commitments. Industry groups signaled concern that tariffs could raise costs and disrupt investments.