Millions of Americans could face rising medication costs as former President Donald Trump moves to impose tariffs on Indian pharmaceutical imports by April 2. The potential trade war threatens to upend the US healthcare system, which relies heavily on affordable Indian generics—accounting for nearly 90% of prescriptions and saving $219 billion in 2022 alone.The tariffs could force Indian drug manufacturers out of the US market, exacerbating existing shortages and driving up costs for patients, particularly the uninsured. Industry experts warn that shifting production to the US is neither economically viable nor feasible in the short term, as building new facilities could take a decade and cost billions.For India, the pharmaceutical sector is its largest industrial export, sending $12.7 billion worth of drugs to the US annually, virtually tax-free. However, with US drug imports to India facing an existing 10.91% duty, Washington is seeking to level the playing field.India’s government has hinted at tariff reductions, a move that could de-escalate tensions. But with pharma supply chains at stake, both nations must act swiftly to avoid a crisis that could impact millions.