Category: Blog

At the beginning of the new administration, there have been threats of tariffs on a wide variety of imported goods and against multiple nations. One such suggested tariff is that on imported pharmaceuticals. In February, the new administration suggested a 25% tariff could be imposed on imported pharmaceuticals. The impact on the healthcare industry will be far-reaching if the tariffs go into effect, as 61% of adults and 20% of children in the United States fill at least one prescription each year. Tariffs are expected to affect both drug pricing and availability, creating higher prices, increasing drug shortages, and affecting health outcomes.

Tariffs on pharmaceuticals are expected to increase drug pricing for consumers. Insurance companies are not designed to handle a twenty-five percent increase in the cost of medications, due to restrictions on pricing from programs like Medicaid, and that will result in a downstream effect on their patients. This could result in reductions in coverage or the removal of certain drugs from insurance coverage. The resulting changes in coverage and costs will fall to patients.

In part, drug pricing would also go up because it could take years and be more costly to create domestic productions for medicines that are currently being produced abroad. Drug pricing is a complex system because drug production involves multiple layers of manufacturing and steps. Some pharmaceutical companies may be better equipped to handle a pharmaceutical tariff because of existing manufacturing facilities responsible for producing active ingredients while others will struggle more because of a high proportion of active ingredients produced internationally. Those that do not have domestic facilities encounter the additional barrier of FDA regulatory requirements in creating new domestic manufacturing plants.

Drug availability is also in question under the proposed tariffs. In response to the tariff threats, some companies have already expedited shipment to the United States for certain drugs. Coupled with chronic shortages of some generic drugs in recent years, tariffs would put pressure on an already fragile industry. Tariffs could result in supply chain disruption. It is also predicted that fragile generic injectables will go into shortage.

The efficacy of tariffs is as yet unclear, but research is being compiled on possible implications. The Brookings Institution compiled research on pharmaceuticals and found tariffs will provide an incentive to increase domestic manufacturing for brand-name drugs only. This would not affect off-patent generic drugs which make up 90% of the volume of drugs and only a fraction of the costs. The study anticipates that a cut into the already small profit margins will lead to products being discontinued and a loss of some quality standards.

It is unclear precisely what tariffs will do to the pharmaceutical and patient care industries, but it is widely expected that changes will come. At a White House event on April 2, reciprocal tariffs were announced, which would have an impact on the pharmaceutical industry. The White House stated there would be “no exemptions.”  On April 9, a 90-day pause on the tariffs was instituted against most foreign countries except China. This pause is a lower reciprocal tariff, at 10%, except in industries with 25% tariffs, like aluminum and steel. Tariffs are expected to impact the pharmaceutical supply on a global level, which may result in “an extreme burden on the patient.”

As of April 4, 2025, there are 103,223 people in the United States waiting for an organ transplant that could save or greatly improve their life. Of those 103,223 people, seventeen of them will be dead by the end of the day. Tomorrow, seventeen more. Every eight minutes, another person is added to the transplant list at the United Network for Organ Sharing (UNOS), the only organ procurement and transplantation network in the United States. Eighty-six percent of those on the list need a kidney, but livers, hearts, lungs, pancreases, and other organs are needed as well. While over 170 million people in the United States are registered donors, only three out of a thousand people will die in a way that allows for deceased organ donation. The simple truth is this: we do not have enough organs. 

The need for organs has only grown in America, largely due to increased longevity and higher rates of obesity associated with organ failure. Both science and public policy changes have offered a variety of creative potential solutions. One concept adopted in parts of Europe is known as “presumed consent,” where citizens choose to opt out of being an organ donor upon death, as opposed to the American system of opting-in. Another idea is to broaden the pool of cadaver donors by expanding the brain death requirement to a “persistent vegetative state” or allowing a potential donor who is soon to die to choose to donate their organs and experience a “death by donation.” While these potential solutions are ripe for controversy and ethical concerns about consent, they only slightly expand the donor pool—and, still, very few people are likely to die in a manner conducive to organ transplantation. A newer idea offers a different set of questions and controversies while having the capacity to almost completely solve the organ shortage crisis: xenotransplantation. 

Xenotransplantation is already progressing in the United States. On March 21, 2024, Mass General Hospital performed the first successful kidney xenotransplantation into a living recipient, done under compassionate use for the recipient with no other option, and extended his life by two months. Furthermore, just recently on February 3, 2025, the FDA approved a clinical trial for patients with end-stage renal disease and the first transplant is expected to take place mid-year 2025. So, what is it? 

Xenotransplantation is a process that uses organs from genetically modified pigs rather than human organs. The genetic modification is done using CRISPR/Cas9, the leading gene editing technology. Pigs are an ideal candidate for xenotransplantation for multiple reasons, including the similarities between pig and human organs, their short gestation period, their large litter sizes, and the present common acceptance of pigs being used as meat animals. Furthermore, the widespread use of pigs for organ transplants would present numerous benefits, including providing a near-unlimited supply of organs, reducing illegal organ trafficking, and allowing “borderline” candidates who would otherwise be denied a transplant an opportunity to have a new organ. 

All this being said, xenotransplantation certainly presents a slew of complications and concerns. On the medical side, there is a possibility of transmitting animal viruses to the recipient and loved ones near the recipient. Furthermore, while pig kidneys are similar to human ones and both filter waste from blood and make urine, human kidneys have many important roles and it is currently unclear if pig kidneys can fulfill these functions long-term (though the longest-living recipient of a pig kidney says she is currently doing very well, months after the transplant). As for the pigs, they must be raised in sterile conditions to reduce the likelihood of infection to the human recipient. The pigs are also genetically modified to make their organs more suitable for humans and reduce the likelihood of animal viruses being transmitted, which has presented a debate on the ethics of using animals in such a way. 

With the FDA giving the green light to clinical trials and the purported success of recent kidney xenotransplants, xenotransplantation appears to be gaining speed. It may present a unique solution to the organ shortage crisis while posing interesting questions about the consequences of using such technology. 

The National Institutes of Health (NIH) is part of the United States Department of Health and Human Services (HHS). It consists of twenty-seven organizations known as Institutes and Centers. The NIH aims to foster creative discoveries and innovative research strategies; develop, maintain, and renew scientific human and physical resources to prevent disease; expand the knowledge base in medical and related sciences to enhance the nation’s economic well-being; and exemplify and promote the highest levels of scientific integrity, public accountability, and social responsibility. Although each Institute and Center has its own research agenda, they all receive their funding directly from Congress. 

The NIH allocates the majority of its $48 billion budget to medical research. A significant portion of this funding is awarded to universities, medical schools, and other institutions to conduct extramural research through grants. One major category supported by the NIH is cancer research, which receives approximately $8 billion annually. Since President Trump took office on January 20, 2025, he and his administration have implemented substantial cuts to federal health agencies. His administration, as of last week, has sent termination notices to thousands of federal health workers, including those at the NIH, which anticipates a loss of 1,200 employees. 

In addition to cuts affecting federal employees at the NIH, the Trump administration has stalled grant authorization and funding. The NIH cannot consider new grant applications because President Trump has blocked it from posting new notices in the Federal Register, a requirement before any federal meeting can be convened. As a result, the agency had to cancel planned meetings to review thousands of grant applications. Due to the freeze, the NIH has reportedly stalled over 16,000 applications, all competing for approximately $1.5 billion in NIH grant funding. An anonymous committee member who reviews grant funding meetings states that even though the freeze remains in place, “applications still come in, and essentially they go into a black hole, and nothing can be done with them.” In addition to workforce cuts, the Trump Administration has hit the NIH with a cap of 15% on the rate they pay for the indirect cost of medical research. This is much lower than many other federal institutions get to maintain buildings and equipment.

Anjee Davis, the CEO of Fight Colorectal Cancer, expresses her fear regarding employee cuts and a funding freeze: “We are scared that these blanket mandates could erase decades of progress in the fight against cancer. This isn’t about politics. It’s about protecting the advancements we’ve fought so hard to achieve in cancer care and research over the past two decades.” Dr. Celine Gounder, CBS News Medical Contributor, explained that the NIH is “how we end up with new drugs and other advancements in medicine.” CBS further explains that while there are immediate impacts from the freeze and firings, concerns grow among individuals that there are both immediate and long-term worries about a slowdown in biomedical research and potential delays in drug approvals. Davis and her company surveyed patients currently being treated for colorectal cancer, and 75% of respondents indicated they were worried that these government actions would delay their care and hinder new research into their cancer. 

While the funding freeze is new, and the federal workforce cuts at healthcare agencies are even newer, there is not much to say to ease the fear and anxiety felt by individuals, more specifically cancer patients. It is very concerning regarding the immediate impact on health care and public health and the longer-term implications for whether we will maintain our leadership in the health space. 

Congress recently passed the Halt All Lethal Trafficking (HALT) of the Fentanyl Act in an attempt to provide a solution for the ongoing opioid crisis. The bill would make the temporary class-wide scheduling order for fentanyl-related substances (FRS) permanent, ensuring law enforcement has the tools to keep these deadly drugs off the streets while allowing practitioners to research their effects on human health. Classifying fentanyl as a Schedule I substance means that those who manufacture, import, or possess FRS with the intent to distribute will face strict mandatory minimum sentences while also expanding mandatory minimums for drug analog prosecutions.

However, the HALT Act has received criticism, with public health experts, criminal justice advocates, and civil rights proponents opposing it. The Act is criticized for expanding mandatory minimum sentences, a proven failure in improving public safety, and warned it would worsen racial disparities in the criminal justice system. By permanently scheduling all fentanyl-related substances, HALT could hinder research on potentially life-saving treatments, as some FRS may have no harmful effects and share molecular similarities with effective antidotes.

The HALT Fentanyl Act would lower trafficking thresholds, making even a trace amount of fentanyl analog in a 10-gram sample subject to a five-year mandatory minimum sentence, compared to the current law where 10 grams triggers a five-year sentence and 100 grams results in 10 years.

In addition, the expanded mandatory minimums strip judges of the ability to tailor sentences based on a defendant’s background and circumstances, shifting more power to prosecutors, who are more likely to charge Black individuals with offenses carrying mandatory minimums, a pattern the HALT Fentanyl Act risks perpetuating and worsening.

Harsh federal drug laws and mandatory minimums have fueled the growth of the federal prison population, with no evidence that they deter crime or reduce drug use, while those convicted of drug offenses now make up 43.9% of the Bureau of Prisons population.

When asked why he voted against the bill, Oregon Senator Ron Wyden explained that it fails to address the root causes of addiction, saying, “The ‘war on drugs’ approach of criminalizing addiction with mandatory, one-size-fits-all minimum sentences has failed for decades to reduce drug use.” 

Susan Ousterman, founder of the Vilomah Memorial Foundation, who lost her son to a fentanyl overdose in 2020, criticized Congress for prioritizing punitive measures over meaningful solutions. She stated that her son died not due to a lack of laws but because he couldn’t access necessary care, calling it hypocritical for Congress to claim commitment to reducing overdose deaths while continuing to pass legislation that perpetuates stigma and incarceration. Ousterman urged Congress to focus on treatment, harm reduction, and addressing social determinants of health to create pathways to healing and recovery.

Harm reduction programs, often run by community or peer-led organizations and health departments, include initiatives like providing sterile syringes, distributing naloxone, offering fentanyl testing, and educating about overdose prevention and safer drug use to reduce the risks associated with drug use.

Harm reduction strategies are proving effective, with the U.S. Centers for Disease Control and Prevention (CDC) projecting a nearly 24% decline in drug overdose deaths in the U.S. for the 12 months ending in September 2024 compared to the previous year. The CDC credits this decrease to factors such as the widespread, data-driven distribution of naloxone, better access to evidence-based treatment for substance use disorders, and shifts in the illegal drug supply.

Ultimately, the HALT Act is a counterproductive effort to halt the opioid epidemic. Congress should focus more on improving harm reduction strategies around the country and less on promoting the war on drugs. 

America suffered a tremendous loss in 2020: nearly 400,000 people died from Covid-19. In the years following, thousands more would die from the raging pandemic. That is until a vaccine with an efficacy against mortality rates of more than 90% brought the spread to a searing halt. Even still, millions of Americans reject vaccines for themselves and their children each year for contagious diseases like Covid-19, measles, and the seasonal flu.

Vaccine hesitancy and distrust originated in the early 1800s, as smallpox erupted across Europe. The technologically advanced smallpox vaccine concerned the first group of “anti-vaccinators.” Some of those who opposed vaccines believed them “unchristian” because they came from an animal and others’ opposition was rooted in their fundamental distrust of medicine in general.  

In the late ‘90s, Andrew Wakefield published a paper claiming that there was a causal link between the MMR (measles, mumps, rubella) vaccine and autism in children. Experts later discovered that Wakefield falsified his data, intentionally misleading readers so that he could sell a competing vaccine. Not only was his data falsified, but his study only included 12 children—a sample size far too small to achieve statistical significance. Wakefield’s license to practice medicine in the U.K. was revoked and the journal that published the paper quickly withdrew it. While Wakefield faced consequences in his personal and professional endeavors, the distrust in vaccines that he bred still lives on in many Americans today. According to a 2024 study by the University of Pennsylvania’s Annenberg Public Policy Center, more than a quarter of American adults still believe that the MMR vaccine causes autism (despite Wakefield’s admittedly falsified data). With measles cases on the rise and vaccination rates decreasing, the lower threshold for measles herd immunity is near; the United States is close to losing its “elimination status” for the extremely contagious disease.

In a post-Covid world, where vaccines have proven their efficacy time and again, distrust continues to grow. The need for calm, informed, sensible leadership is exigent in the United States. Instead, the Trump administration called on Robert F. Kennedy Jr. to lead the charge. A known anti-vaccine activist, Kennedy has promulgated misinformation, claiming that, among other things, vaccines cause autism. On a podcast in July 2023, Kennedy said, “There’s no vaccine that is safe and effective.”

Where do we go from here? In this critical moment, the onus is on state and local governments to educate their communities, provide emergency response support, and implement state-based vaccine programs. Healthcare providers can ally with local groups to communicate with the public and continue to push back against billions in childhood vaccination funding cuts. In a time where the truth is a hard sell, providers and local governments must put it on the shelves anyway.

In 2022, the U.S. Supreme Court issued an unprecedented ruling in Dobbs v. Jackson Women’s Health Organization which eliminated the constitutional right to abortion. This decision has led to widespread repercussions with abortion bans in effect in forty-one states, twelve of which have imposed a ban as early as six weeks from conception when many do not know they are pregnant. Pregnancies may result from sexual assault or pose a severe health risk to the pregnant individual; however, exceptions for such circumstances are inconsistent. For instance, both Louisiana and Arkansas have enacted a complete abortion ban with no exceptions for rape or incest whereas Alabama only provides an exception for rape. Despite the diminishing access to abortions in these states, studies have shown that almost all other states have experienced an increase in the number of abortion procedures sought and provided.

As states continue to implement stringent abortion restrictions, alternative options such as medication abortion have become more commonly pursued by pregnant individuals. Medication abortion, also known as “abortion pills,” is a process of ending a pregnancy through remedial measures. The process entails oral administration of two capsules that stop the pregnancy and induce uterine contractions which expel the pregnancy tissue. Notably, in the six months after Dobbs, the provision of prescriptions for self-managed abortions increased. However, anti-abortion groups have encouraged the criminalization of these alternative methods. Notwithstanding political opposition, the Food and Drug Administration (FDA) has approved the use of the medication to safely and effectively end pregnancies of up to eleven weeks.

Amid state bans and limitations on medication abortion, novel constitutional questions about interstate relationships have surfaced. On January 31, 2025, a grand jury in West Baton Rouge Parish, Louisiana indicted a New York physician for allegedly prescribing and mailing abortion pills to a minor. After the indictment, New York Governor Kathy Hochul denied Louisiana Governor Jeff Landry’s request to extradite the physician under the authority of New York’s shield law. While various states have passed “shield laws” to protect doctors from extradition for mailing abortion pills out of state, this is the first instance in which such laws have been tested. In its aftermath, this case sparked fear among medical professionals that merely providing telehealth abortion care, even if permitted by their state, may ultimately lead to persecution.

In light of escalating constraints placed on access to reproductive health care, studies have further revealed that there are many facing significant consequences. Namely, racial and ethnic minority groups are disproportionately represented in pregnancy-related deaths and individuals face increased barriers barring access to contraceptives. Such restrictions are associated with surging infant and neonatal mortality rates and an 11% increase in foster care entries. Hence, the most recently discussed case on medication abortions and shield laws is crucial to safeguard those providing and receiving essential reproductive health care.