If dietary supplements are part of your clinical practice, prepare yourself—and your patients—for price shocks in the coming months.

As the Trump administration tariffs take effect, supplement prices will surge.

Roughly 80% of all raw materials in nutritional, botanical, and natural health products sold in the US come from overseas. China and India are the major producers, but European countries like Germany, France, Italy, and Poland are also significant players. Most product bottles, blister pack materials, excipient ingredients, and manufacturing equipment are also made outside the US.

A lot of these things will be subject to the new tariffs, and those tariffs are hefty.

In addition to the basic 20% General Duties tariff the administration wants to impose on all imports, certain raw materials could also be subject to additional country-specific duties of up to 125%, if the administration proceeds with its reciprocal tariffs plan under the president’s invocation of the International Emergency Economic Powers Act (IEEPA).

“Eye-Watering” Increases

Higher raw materials costs mean higher prices not just for supplements, but also for drugs, personal care products, medical devices. And that’s on top of soaring costs for other imports like cars, electronics, clothing, building materials, and food.

“The current givens are that dietary ingredient prices will rise, by a lot in some cases,” says Loren Israelsen, executive director of the United Natural Products Alliance (UNPA), an industry trade organization that is tracking the tariff onslaught very closely.

Israelsen predicted, “eye watering price increases” on practitioner channel nutraceuticals and botanicals, many of which already on the premium end of the pricing spectrum. “It will be a problem,” he told Holistic Primary Care. “Prepare to tell patients why the dietary supplement prices will go up.”

Some practitioner-focused brands have already issued “Dear Doctor” letters stating they are doing everything possible to find domestic ingredient sources and to absorb the tariff costs, but that wholesale price hikes are inevitable. At the same time, raw materials suppliers are pitching brand customers to grab the last of the tariff-free ingredient stockpiles before prices skyrocket.

“The current givens are that dietary ingredient prices will rise, by a lot in some cases It will be a problem. Prepare to tell patients why the dietary supplement prices will go up.”

–Loren Israelsen, United Natural Products Alliance

The American public’s appetite for dietary supplements and other natural products proved remarkably resilient through the financial crisis of 2008-2009, the Covid pandemic, and the post-Covid inflationary cycles. But industry watchers question whether that resilience can withstand a tariff-induced pricing surge.

Seeking the “Exemptic” Rx

Across all industries, business leaders are talking to their lobbyists and legislators about “Exemptic,” in the hopes of mitigating the symptoms of Severe Geopolitical Unpredictable Economy Stress Syndrome (GUESS). They’re working to convince the government to spare their most important raw materials from the tariffs.

Generally speaking, the Fed will exempt imported materials from tariffs if: A) they are very widely used and considered beneficial; B) domestic production is non-existent or very limited; and C) tariff-induced reductions on import would lead to widespread shortages, resulting in major disruptions of important US business sectors.

Under the Annex II component of Trump’s reciprocal tariff policy, the administration has exempted a number of nutritional ingredients from the global and country-specific tariffs. These include ‘letter’ vitamins, most major minerals, co-enzyme Q10, quercetin, chondroitin, EPA, DHA, glutathione, and many commonly used amino acids.

Simply put, there is no US production of these raw materials, meaning that the US supplement industry—a $50 billion to $78 billion business sector, depending on whose numbers you believe—is reliant on imports. The Annex II exemptions will somewhat cushion the overall tariff blow.

Herbs Take Heavy Hit

But as of mid-April, no medicinal herbs or botanical ingredients have been exempted. The only exception is stevia, widely used as a “healthy” sweetener. All other botanicals, including popular ones like Turmeric, Ashwagandha, Elderberry, Ginseng, Black Cohosh, Boswellia—even Green Tea—are subject to the tariffs. Combined, the new tariffs could add an additional 150% to the costs of many herbal raw materials.

Similarly, probiotic ingredients have not been officially spared. Without exemptions, these two sectors are particularly vulnerable to post-tariff price surges.

A quick look at Annex II raises questions about the logic of exemptions. For example, EPA and DHA as individual ingredients are exempted from the IEEPA portion of the tariffs. But “Omega 3 fatty acids” as a category are not, and they could be subject to an IEEPA levy of up to 125%.  Logically, this makes little sense, since EPA and DHA are omega-3 fatty acids.

This, and other idiosyncracies raise questions about the degree to which the exemption criteria are evenly applied, and whether or not other factors like pressure from particular industries play a role in determining which materials will be tariffed and which will be spared.

Supplement industry trade groups have been actively pushing for wider exemptions. In a letter to the Trump administration dated April 16, the UNPA underscored concerns about ingredients in infant formulas as a pressure point with the government.

“Your inclusion of essential vitamins, amino acids and other key dietary ingredients

As of mid-April, no medicinal herbs or botanical ingredients have been exempted. The only exception is stevia, widely used as a “healthy” sweetener. All other botanicals, including popular ones like Turmeric, Ashwagandha, Elderberry, Ginseng, Black Cohosh, Boswellia—even Green Tea—are subject to the tariffs.

in Article II has protected much of this critical supply chain. However, we note that several key ingredients in infant formula such as essential fatty acids, biotin, calcium and magnesium are not in Annex II and we ask for your consideration of their inclusion,” the letter states.”

Tariffs in Context

The Natural Products Association, another trade organization, is encouraging member companies, and all concerned parties, to look at the tariffs from a bigger-picture viewpoint. Though the tariffs will cause some pain, NPA’s position is that in general the Trump 2.0 team is far friendlier toward supplements and natural medicine than any previous administration, and this will ultimately be good for business.

In an official statement dated April 4, NPA acknowledged that some important raw materials have not been exempted. But the group expressed gratitude to the Trump administration “for recognizing the critical importance of maintaining a strong supply chain for this industry, which supports American manufacturing and promotes public health. The administration’s commitment to ensuring a stable, cost-effective supply of these materials aligns perfectly with the mission of Making America Healthy Again.”

NPA’s CEO, Daniel Fabricant, PhD, praised the president’s “willingness to listen” to the industry’s concerns. “We are excited to continue collaborating with this administration to prevent any supply chain disruptions and to explore innovative solutions, like reshoring, that will strengthen our industry and create American jobs.” Prior to assuming leadership of NPA, Fabricant was director of the FDA’s Division of Dietary Supplement Programs.

Uncertainty Reigns

Fabricant’s sanguine assessment of Trump’s trade policies was not shared universally among raw materials suppliers and ingredient purchasers who gathered in mid-April for the annual SupplySide Connect (formerly SupplySide East) trade show in Secaucus NJ.

Most were dumbstruck by the magnitude of the proposed tariffs, the lack of clarity on which ingredients and which countries ultimately will and will not be exempted, and the sheer uncertainty about the timing of the tariff implementations.

On April 9, one week after he presented the new tariff scheme, Trump announced a 90-day suspension on enactment of the proposed country-specific tariffs, applying a temporary baseline rate of 10% on imports from all countries except China which was slapped with a broad 125% import tariff.

The purpose of the pause is to give the administration time to hash out specific deals with trading countries, while simultaneously giving US importers, exporters, manufacturers, and retailers a period to adjust—and that’s the polite way to say it–to the new global trade realities.

Based on feedback from participants at SupplySide, the impact so far has been massive confusion and uncertainty. 

Rancor & Recklessness

For many therapeutic ingredients, neither the ingredient suppliers nor the purchasers know what raw materials costs will be in 2 months’ time. Depending on the willingness of other nations to negotiate with Trump and company, the impact of the tariffs could vary widely from country to country.

This makes life especially difficult for supplement brands who purchase myriad ingredients from multiple suppliers in different countries. If executives don’t know what their base costs will be, they don’t know how to adjust their wholesale or retail pricing.

Moreover, the rancorous rhetoric and haphazard rollout of the tariffs have torn up the delicate ecosystem of supply chain relationships, engendered a lot of bad will, and fomented mistrust.

Docking fees are a major flashpoint. In addition to the enumerated tariffs, the Trump administration is phasing in a series of new docking fees for Chinese owned and operated ships entering US ports. Announced on April 18, these fees begin immediately at $50 per net ton of goods, and will increase by $30 per net ton every year for the next 3 years. In contrast, non-Chinese ships will be hit with initial docking fees of $18 per net ton, with $5 per ton yearly increase.

We’re talking here about massive container ships carrying huge quantities of cargo. The new fees add anywhere from $1 million to $3.5 million in additional costs per ship.

Already some supplement companies have reported that the docking fees—and disputes over who will ultimately bear those costs—have interfered with shipment of raw materials that were already under contract. Nobody making purchase agreements 3 months ago was expecting to factor in an additional million dollars for docking charges.

Many in the industry are also concerned that price hikes on raw materials will spur a massive increase in ingredient adulteration and substitution—something the supplement industry made major strides in controlling over the past decade. The safety and reliability of imported raw materials could be compromised under the new tariffs.

FDA Under MAHA

The tariff situation is mind-boggling enough, but keep in mind that it is playing out in the context of extreme regulatory uncertainty.

Nobody knows how the FDA will function under incoming commissioner Martin Makary, with oversight by Robert F. Kennedy, Jr, and stripped of 5,200 former employees, including 89 expert staffers in the nutrition and food safety space.

Anna Benevente, Director of Product, Label & Ingredient Review, at Registrar Corp—a consulting agency that helps international nutrition, drug, and medical device companies navigate and comply with the FDA’s regulations, says her clients are at a loss on how to proceed in doing business with the US.

“We’re getting a lot of questions right now about the tariffs and how that’s going to impact their ability to send products into the US. But they want to know what the new administration’s approach to regulation will be, and how that might be different than Biden’s and how it’s been in years past. Everybody’s in wait-and-see mode,” Benevente told Holistic Primary Care.

She noted that historically, Republican administrations have frowned on intensive government regulation of industry. So, it is possible that an FDA under MAHA guidance—and with a much smaller workforce–could be more lenient.

That said, there’s nothing ‘typical’ or predictable about Trump when it comes to policy-making. The fact that this is a “Republican” administration guarantees very little.

Benevente said she and her colleagues at Registrar Corp are telling their clients not to panic, but to watch the situation closely and wait for the silt to settle. She acknowledged that, “our crystal ball is very cloudy right now.”

Pharma Feels It, Too

The supplement industry is not the only healthcare sector feeling tariff terror. The new duties will hit Big Pharma, too. According to industry estimates, nearly half (47%) of all active pharmaceutical ingredients (APIs) used in US drug products are produced outside the US. That’s approximately $86 billion worth of drug-making ingredients imported annually.

Ireland is the biggest producer, manufacturing roughly 22% of all APIs used in the US. China and India, which are major API producers for other global market sectors, account for just 6% and 2%, respectively, of US APIs.

The administration has already exempted 72% of the commonly used basic APIs, and 84% of all finished pharmaceutical products being imported to the US. In aggregate,  only a relatively small percentage of total APIs are subject to the tariffs.

Tariffs Pummel Med-Tech

The medical device and diagnostics sector—a $612 billion industry–is also vulnerable to acute tariff-itis. Roughly two-thirds of all medical devices used in the US are manufactured outside the country, according to Food and Drug Administration data.

Nearly 27% come from Mexico, with Germany, Costa Rica, and Ireland accounting for 12%, 9% and 8% respectively. Surprisingly, China accounts for less than 8% of all medical devices imported into the US.

Unlike its behavior toward imported pharma ingredients, the Trump administration has not granted broad tariff exemptions for medical devices. At least, not yet. There are some exceptions such as certain disability- or disease-related equipment. But on the whole, the administration sees devices as fair game for full-on tariff pressure.

Device industry groups fear not only the cost impact of the import tariffs but also the blows that will come from reciprocal tariffs on US-made gear in countries that buy a lot of American med-tech.

AdvaMed (Advanced Medical Technology Association), which represents more than 500 device companies, is urging the Trump administration to stop the trade war and instead embrace a “zero-for-zero” model based on humanitarian exemptions. The American Hospital Association has also joined the call for medical equipment exemptions.

AdvaMed president and CEO, Scott Whitaker, contends that the present path toward all-out global trade warfare will wreak havoc on the device industry, and ultimately will undermine healthcare here and abroad.

“Let us compete fairly, evenly, no tariffs. Let us serve patients as best we can, let’s impact peoples’ lives, and the best companies are going to win. That’s the way the system should work,” Whitaker says.

Complex Global Game

UNPA’s Loren Israelsen says it is difficult to grasp the scale of the changes we are now witnessing. “This is a complex global game we are now caught up in, a total reset of the global economic and trade order, and that process is not orderly.”

He said the current trade wars are baffling the best minds in the business world, and this is leading to fear, inaction, and of course higher prices.

Trade policy is changing by the week, and what’s true today may not be true in a month’s time. UNPA has established a working group to monitor the tariff situation from all angles, including a concerted effort to track actual costs for key ingredients, along with changes in retail pricing for nutraceutical and herbal products.

It remains to be seen whether the Trump administration’s trade shake-ups will ultimately make American industries healthier. For the moment they’re wreaking havoc.

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