President Trump announced a 100% tariff on branded pharmaceutical imports effective October 1 unless companies are actively building manufacturing plants in the U.S., defined as at groundbreaking or under construction stages. Small and mid-size biotechs face significant exposure. Although generics are exempt, tariff investigations extend into med-tech and industrial machinery sectors. The move upends months of ongoing negotiations and bilateral trade deals, injecting uncertainty into pharma supply chains and investment strategies. Industry observers await clarifications on exemptions and regulatory impacts amid opposition and strategic company responses.