The U.S. gets the vast majority of common, generic medications from China, meaning President Donald Trump’s steep tariffs on Chinese imports could cause a shortage of key drugs. Generic drugs are affordable because of manufacturers’ razor-thin margins. Increased costs as a result of tariffs could disincentivize them from producing certain pain-relief meds.

Tariffs already have many Americans concerned about the state of the economy, but the incoming taxes on pharmaceutical goods from China could present a more literal headache.

The U.S. gets nearly all of its supply of common over-the-counter pain medications from China, meaning President Donald Trump’s 145% tariffs on the country could have an outsize impact on the U.S.’s method of sourcing key drugs, Apollo chief economist Torsten Sløk said in a Wednesday blog post. About 95% of the U.S.’s ibuprofen comes from China, Slløk noted, citing data from trade-protectionist advocacy organization Coalition for a Prosperous America and the National Institutes of Health’s National Center for Biotechnology Information.

More than 90% of the supply of anti-inflammation steroid hydrocortisone also comes from China, as well as 70% of acetaminophen and 45% of the U.S.’s penicillin imports. The U.S. is particularly reliant on China for more affordable, generic drugs, and generic drugs make up 90% of prescriptions filled in the U.S., according to the Food and Drug Administration.

Tariffs have already more broadly threatened the availability of consumer products in the U.S. as American companies stockpiled goods before the tariffs went into effect, only to pull back once those products became more expensive.

“The consequence will be empty shelves in U.S. stores in a few weeks and COVID-like shortages for consumers and for firms using Chinese products as intermediate goods,” Sløk said in an April 25 post.

These shortages are imminent, according to Gene Soroka, executive director of the Port of Los Angeles, the U.S.’s largest port, which receives about 45% of its imports from China. Seroka has begun to see a “precipitous drop” in shipments from China that will result in only five to seven more weeks of full inventories on retail shelves, he predicted.

The White House did not immediately respond to Fortune’s inquiry on plans to exempt medications from tariffs.

Exacerbating a drug shortage

For America’s drug supply, tariffs could make a bad problem worse.

The U.S. has contended with stubborn drug shortages in the past three quarters, with 270 active shortages as of March 2025, but down from the all-time high of 323 shortages in early 2024, according to trade organization American Society of Health-System Pharmacists. These shortages can be caused by natural disasters temporarily halting production or regulatory challenges.

Key players in the pharmaceutical industry fear tariffs will pile onto the factors driving the scarcity. Profit margins for generic drugs are incredibly thin to keep them affordable, meaning some manufacturers could stop producing drugs that are too expensive to make as a result of the increased cost of raw materials, according to John Murphy, president and CEO of trade group Association of Accessible Medicines (AAM). To make matters worse, Murphy said, any hiccups in the supply chain will also likely mean an increase in drug prices for consumers.

“AAM is concerned…that any duties on pharmaceutical products, particularly inputs, will lead to increased costs of manufacturing generics and biosimilars in the United States and, thus, result in higher prescription drug prices and decreased access for patients in our country,” Murphy said in a March letter to U.S. trade representative Jamieson Greer.

Despite Trump’s intention with tariffs as encouraging domestic production, American pharmaceutical companies may be hesitant to take a chance on increasing their own manufacturing capabilities, Marta Wosińska, health economist and senior fellow at the Brookings Institution, told USA Today. The future of tariffs—with Trump now considering “substantially” cutting the levies—creates too much unpredictability for drug companies to take meaningful steps to address them.

“Making a billion-dollar investment in the United States when I don’t even know whether tariffs are going to be there a month from now makes it a really difficult calculus for companies,” Wosińska said.

Tariffs threaten a pharmaceuticals shortage, as 95% of ibuprofen comes from China