“If enacted across the board, Trump’s order would mean pharmaceutical companies must sell drugs to Americans at the lowest prices they were offering anybody else in the world.”
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“Americans do pay significantly more for prescription drugs than people in other developed nations, but the reasons for that are more complicated than Trump suggests.
“There are many good reasons why we should pay more for earlier access to new medications than our trading partners,” wrote Darius Lakdawalla and Dana Goldman of the University of Southern California’s Schaeffer Institute for Public Policy & Government Service. “As the world’s largest market for pharmaceuticals, America finds itself in the unique position of accruing the lion’s share of the benefits from new medicines. We often recoup these additional costs in the form of longer and healthier lives.””
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“”facing a choice between deep cuts in their U.S. pricing or the loss of weakly profitable overseas markets,” the companies may simply exit foreign markets altogether, “leaving U.S. consumers with the same prices, pharmaceutical manufacturers with lower profits, and future generations with less innovation.””
“Bondi’s most obvious mistake is equating potential overdoses with actual overdoses: She assumes that 258 million opioid-naive people would each have consumed two milligrams of fentanyl in one sitting. But Bondi also erroneously assumes that seizing 3,400 kilograms of fentanyl is the same as reducing U.S. fentanyl consumption by that amount.
That is obviously not true. Prohibition allows drug traffickers to earn a hefty risk premium, which gives them a strong incentive to find ways around any barriers the government manages to erect. Given all the places where drugs can be produced and all the ways they can be smuggled, it is not possible to “cut off the flow,” as politicians have been vainly promising to do for more than a century. The most they can realistically hope to accomplish through interdiction is higher retail prices resulting from increased costs imposed on drug traffickers.
That strategy is complicated by the fact that illegal drugs acquire most of their value close to the consumer. The cost of replacing destroyed crops and seized shipments is therefore relatively small, a tiny fraction of the “street value” trumpeted by law enforcement agencies. As you get closer to the retail level, the replacement cost rises, but the amount that can be seized at one time falls.
These challenges—which are compounded in the case of fentanyl, a highly potent drug that can be transported or shipped in small packages containing many doses—explain why interdiction never seems to have a significant and lasting impact on retail prices. From 1981 to 2012, according to the Office of National Drug Control Policy, the average, inflation-adjusted retail price for a pure gram of heroin fell by 86 percent. During the same period, the average retail price for cocaine and methamphetamine fell by 75 percent and 72 percent, respectively. In 2021, the Drug Enforcement Administration reported that methamphetamine’s “purity and potency remain high while prices remain low,” that “availability of cocaine throughout the United States remains steady,” and that “availability and use of cheap and highly potent fentanyl has increased.””
“The study included 2,653 drug seizures and 1,833 opioid-related deaths from 2020 to 2023. “Within the surrounding 100, 250, and 500 meters,” RTI International researcher Alex H. Kral and his two co-authors reported in JAMA Network Open on Wednesday, “drug seizures were associated with a statistically significant increase in the relative risk for fatal opioid overdoses.””
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“Prohibition makes drug use more dangerous by creating a black market in which quality and potency are highly variable and unpredictable. Ramped-up enforcement of prohibition magnifies that problem, as dramatically demonstrated by the deadly impact of restricting access to pain medication at the same time that illicit fentanyl was proliferating as a heroin booster and substitute.”
“the cost of site construction might rise further because of the 25 percent tariff Trump has imposed on steel, a major input in industrial construction”
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““The same concern applies to manufacturing equipment, which is all stainless steel,””
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“What actually encourages companies to move — as Trump alluded to when he called out Dublin — isn’t tariffs, said Ned Hux, a pharmaceutical and life sciences tax partner at PwC.
“Targeted tax incentives, streamlined regulatory approvals, and prioritized government procurement could make U.S.-based production more attractive and competitive,” he said, adding those measures could come in the form of tax deductions, lower tax rates on manufacturing activity, tax credits and low-interest financing for domestic production.”
“The Food and Drug Administration earlier this month fired dozens of staffers responsible for going after retailers who illegally sell tobacco to minors.
Now it’s begging them to come back.
Senior FDA officials asked laid-off employees in recent days to temporarily return after mass cuts decimated the agency’s ability to penalize retailers that sell cigarettes and vapes to minors, four federal health officials familiar with the matter said.”
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“Without aggressive federal oversight, stores would face far less incentive to turn away underage buyers. That could open the door to a reversal in youth tobacco use rates, experts said, undercutting the fight against chronic disease that Kennedy has vowed to make the centerpiece of his agenda. The civil penalties office also served as a key tool in combating growing sales of illicit vapes.
People who smoke cigarettes, use e-cigarettes or other tobacco products primarily begin before they turn 18, research shows, elevating their risk for a range of chronic diseases like lung cancer and heart disease.”
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“It remains unclear why HHS gutted the office focused on civil penalties, which is known within FDA’s tobacco enforcement apparatus as the Division of Business Operations. The Center for Tobacco Products is funded entirely by user fees paid by industry, meaning the terminations won’t create any taxpayer savings. Instead, officials said, it may end up costing money; the fines that the FDA collects from retailers are funneled directly to the federal treasury.
Kennedy, who has singled out smoking as particularly detrimental to Americans’ health, argued in a recent CBS News interview that all the jobs eliminated across HHS were either administrative or deemed redundant.
“In some cases, we cut programs, but we only did that when we consolidated them into another program,” he said. “So the task will continue, their mission will continue. The people are still there for the most part.”
Yet within the FDA, the officials said the cuts effectively collapsed its tobacco enforcement operation.”
“When President Donald Trump announced his nomination of Pam Bondi as attorney general, he extolled her “incredible job” in “work[ing] to stop the trafficking of deadly drugs and reduc[ing] the tragedy of Fentanyl Overdose Deaths.” Yet those deaths exploded on Bondi’s watch as Florida’s attorney general.”
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“Bondi’s fans praised her for cracking down on “pill mills,” which may have made it harder for nonmedical drug consumers (as well as bona fide patients) to obtain prescription opioids such as hydrocodone and oxycodone. But the result was increased consumption of black market alternatives, which are much more dangerous because their quality and potency are highly variable and unpredictable. That hazard was magnified by the simultaneous proliferation of illicit fentanyl as a heroin booster and substitute—a development that likewise was driven by prohibition, which favors more potent drugs that are easier to conceal and smuggle.”
“States’ efforts to create and then tightly regulate legal markets for pot have, ironically, made the black market for weed bigger than it’s ever been.”
“None of this will do much to stop “dangerous narcotics” from entering the United States, which is Trump’s avowed goal. Interdiction efforts are doomed by the economics of drug prohibition, a challenge that is compounded by fentanyl’s potency, which allows traffickers to distribute large numbers of doses in small packages by land or mail. And Mexican cartels are already working on domestic production of fentanyl precursors in case shipments from China are curtailed. Despite those realities, Trump can still falsely claim he is winning the war on drugs by citing misleading metrics.
Trump said the tariffs would remain in place until the targeted countries took “adequate steps to alleviate the opioid crisis.” Since that criterion is deliberately vague, Trump can simply declare that whatever Mexico, Canada, and China agree to do is “adequate.”
In case that seems too slippery, Trump could cite drug seizure numbers as proof of his success. The beauty of this approach is that Trump can claim victory no matter which way the numbers go.
Given Trump’s promise to “seal the border,” you might expect U.S. drug seizures to go up. But he has previously argued that increased seizures are a sign of failure rather than success.”
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“Unlike “adequate steps” and drug seizure numbers, overdose deaths are a clear measure of whether the “opioid crisis” is getting better or worse. The good news is that drug-related deaths fell precipitously last year after climbing nearly every year for more than two decades. According to preliminary CDC estimates, the death toll during the year ending last August was about 22 percent lower than the total for the previous year—by far the biggest such drop ever recorded.
Inconveniently for Trump, that dramatic decrease happened on Biden’s watch, and there is little reason to think interdiction had anything to do with it. So even if the apparent turnaround continues this year, attributing it to Trump’s tariff-assisted war on drugs would be highly implausible. We can nevertheless expect that Trump will do just that.”
“In exchange for the delay of these tariffs, the Mexican government agreed to send 10,000 national guard troops to its northern border while Trump vowed to stem the flow of American firearms into Mexico. Canada, meanwhile, pledged to implement its 1.3 billion border security plan (which it had already enacted in December). Trump posted on his Truth Social platform that he was “very pleased with this initial outcome, and the Tariffs announced on Saturday will be paused for a 30 day period to see whether or not a final Economic deal with Canada can be structured.””