Studies confirm it: one in three Americans can’t afford to take recommended doses of prescription drugs because of skyrocketing prices. Even the price tag for low-cost  generic drugs has risen so much that some consumers are cutting their doses in half, or skipping them entirely, to stretch out a month’s supply. 

Then, President Donald Trump took office and vowed to bring down prescription drug prices. But experts say his plan — threatening tariffs as high as 100% on drugs imported from China and India, the world’s leading pharmaceutical manufacturers — will make matters worse, hiking prices even higher and potentially triggering shortages at pharmacies.

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That’s bad news for Black people, who have disproportionately high rates of chronic diseases that require daily medication, like heart disease and high blood pressure. Given that Black consumers already struggle more than white people to pay for prescription medication, any price hike could put some medications out of reach. 

And because Black communities often are “pharmacy deserts” — neighborhoods where drug stores are few and far between — critical, potentially life-saving prescriptions could be not only more expensive but harder to find in some areas.

“[When] looking at major issues with hypertension, mental health, diabetes, and how these products are brought into the market, it’s staggering,” says Kathleen Jaeger, a spokesperson for the Indian Pharmaceutical Alliance, a coalition of generic drug manufacturers. “So, if there is no generic on the market, that actually pushes patients to buy the brand products, which are going to cost five to 10 times more.” 

Managing Chronic Diseases Will Get Dicier

In 2024, Americans’ spending on prescription drugs grew by $50 billion annually, an 11.4% increase from the year before. Approximately 90% of all prescriptions in the U.S. are filled with generic drugs, and policy analysts estimate that a tariff as low as 25% could increase U.S. drug costs by as much as $51 billion annually. 

An estimated six in 10 American adults take at least one prescription drug, but one-quarter of them have problems paying for their medication. Roughly 30% say they already can’t afford to take their medication as prescribed. The same percentage said they had to cut their spending for food or clothing to pay for their prescriptions. 

Yet while nearly half of all U.S. adults have cardiovascular disease — a condition that usually requires daily medication — almost 60% of Black Americans live with this condition. Nearly 18% of Black people live with diagnosed or undiagnosed diabetes, which is typically managed with regular doses of insulin or other drugs; the same percentage manage chronic anxiety, another condition that is usually treated through a prescription. The same is true for depression: more than 22% of Black people struggle with the disorder.

The White House argues Trump’s tariffs on India and China are, in part, intended to promote domestic drug manufacturing, but the process of building a pharmaceutical factory in the U.S. could take years. Meanwhile, when the tariffs kick in, people with chronic illnesses will have to pony up for name-brand versions of prescription drugs — which can be double or triple the price of the generics. 

For instance, Prinivil, a brand-name drug used to treat cardiovascular disease, can cost as much as $347 for a month’s supply, but the price tag for lisinopril — the generic version — is as low as $12.77 per month. 

Another drug, Elavil, which treats mental health disorders, costs $71 for a 90-day supply of the brand-name version, while the generic version sells for as little as $15 for the same amount, according to Jaeger’s organization.

If tariffs and shortages nudge a $10 to $20 generic prescription copay closer to a $30 or $40 copay — or force a temporary switch to a pricier, brand-name drug  — that increases the likelihood a patient will skip a dose. That choice, experts say, can prolong a short-term illness or lead to a worsened health outcome for a chronic condition. 

Price Increases Will Hit Black Americans Hardest

Still, bearing the pain of price increases at the drug store depends on whether there is even a pharmacy that can fill the prescription. 

Research shows pharmacy closures disproportionately affect low-income and Black communities. Combined with higher drug prices, this problem also makes it harder to fill prescriptions or access vaccines, such as for the flu or COVID. 

Some entrepreneurial businesses have stepped in to help low-income patients.

On Monday, PhRMA announced that its AmericasMedicines.com will be available to consumers starting January 2026. The site is designed to enable patients to purchase certain medications directly from drug manufacturers. But there are no details on which pharmaceutical manufacturers will participate and which specific drugs they will offer. 

The next day, Donald Trump announced that Pfizer, a major pharmaceutical company, had agreed to lower the cost of prescription drugs for the Medicaid program. Pfizer also stated that it would participate in the Trump administration’s new website, which will enable consumers to purchase drugs directly from manufacturers at an average discount of 50%. As of Wednesday, reports indicate that Trump has backed down from imposing 100% tariffs on imported medicines since manufacturers say they are taking steps to lower prices. There’s no word on whether there will be lower tariffs on pharmaceuticals.

Discount services like GoodRx and The Mark Cuban Cost Plus Drug Company offer programs to help consumers afford the medications they need. GoodRx is a free service that lets consumers compare pharmacy prices and use coupons to lower their costs. Cost Plus sells medicines at the manufacturer’s price, plus a small fee. This is usually much lower than the retail markup, especially for generic drugs.

Jennifer Porter Gore is a writer living in the Washington, D.C., area.