Trade, Not Tariffs, Will Keep U.S. Healthcare Competitive

America leads the world in medical innovation. That stark advantage exists not because the U.S. goes it alone, but because the U.S. recognizes and adopts the best ideas wherever they emerge. Nowhere is this more evident than in the biopharmaceutical sector, where cross-border collaboration plays a central role in how new treatments reach patients.

Medical breakthroughs don’t heed geopolitical borders. Many of the treatments keeping patients alive today started with foreign research and development (R&D) but are now trialed, manufactured, and distributed through American infrastructure. For example, Boston Scientific acquired a U.K.-based company behind a promising cancer therapy known as TheraSphere in late 2018. Today, that innovation is being advanced through U.S.-based clinical trials and manufacturing. The treatment has secured Food and Drug Administration (FDA) approval and reduced disease progression by more than 30 percent during phase III trials, giving American patients access to new treatment options while supporting jobs and research at home. Rather than weakening U.S. industry, this global-to-local pipeline is what keeps the life sciences ecosystem competitive.

Unfortunately, this model is under threat. A wave of misguided “Buy America” mandates and trade barriers, including the pending threat of Section 232 tariffs, risks disrupting a system that is working well and protecting American health. These policies may sound appealing on the campaign trail, but they don’t stand up to scrutiny. They raise prices, fragment supply chains, and make it harder for companies to reinvest in the U.S.

Tariffs on pharmaceutical inputs are an excellent example of this disturbing phenomenon. Many U.S. firms operate global supply chains, sourcing raw materials or active pharmaceutical ingredients from abroad before scaling production domestically. Taxing those internal transfers does nothing to protect American workers. In fact, an April 2025 Ernst & Young analysis found that a 25 percent tariff on pharmaceutical imports could raise U.S. drug costs by $51 billion a year and increase prices by as much as 12.9 percent. For inputs used in domestic manufacturing, the same tariff would raise production costs by 4.1 percent, undermining U.S. competitiveness and threatening thousands of export-supported jobs.

Biopharma doesn’t need a mandate to invest at home. It’s already among the top three sectors investing in U.S. manufacturing and the largest goods exporter among all R&D-intensive industries, with a 2023 export total of over $101 billion. Since 2016, capital investment in biopharma plants and equipment has grown by over 72 percent, with more than $126 billion committed between 2018 and 2022. Today, the U.S. is home to nearly 1,600 biopharmaceutical manufacturing facilities.

Across the country, companies are doubling down on U.S. investment. Eli Lilly has committed more than $50 billion in U.S. manufacturing investments since 2020, including four new production sites expected to create over 3,000 jobs. Johnson & Johnson recently announced plans to invest another $55 billion over the next four years, and Bristol Myers Squibb has committed $40 billion over the next five years, all fueling advanced medical manufacturing, R&D, and job creation across the country. This September, Gilead broke ground on a major pharmaceutical development and manufacturing hub in California as part of its $32 billion domestic investment plan—a project expected to generate more than 3,000 direct and indirect jobs and contribute $43 billion in value to the U.S. economy. Since 2017, U.S. biopharma companies have collectively invested more than $624 billion in research and development, and the bioscience industry supports over ten million American jobs today.

This success isn’t the result of mandates; it came from smart, pro-growth policy. The Tax Cuts and Jobs Act helped reverse a long-running trend of corporate inversions and foreign takeovers. From 2021 through 2024, more than 80 percent of large biopharma and medical device acquisitions were led by U.S. companies—keeping innovation, intellectual property, and high-wage jobs here at home.

“Buy America” mandates in healthcare threaten to unravel that progress. Biopharma already produces nearly two-thirds of U.S.-consumed medicines domestically. It’s not about willingness to invest in the U.S. It’s about giving companies the flexibility to do so without artificial constraints. Forcing U.S. companies to cut off foreign inputs won’t create new jobs. It will create higher prices and longer waits for patients.

Instead of punishing companies for building global supply chains, Congress should protect the environment that made these investments possible in the first place. That means resisting broad-based tariffs and maintaining a tax environment that rewards U.S. investment.

Innovation should rise or fall based on its value, not its country of origin. In biopharma and beyond, the U.S. has led not by retreating from the world, but by attracting the world’s best ideas and building them here at home. If lawmakers want to help patients and strengthen the economy, trade needs to be able to do its job.