LONDON, April 9 (Reuters) - U.S. President Donald Trump

late on Tuesday reiterated he would impose tariffs on imports of

pharmaceutical products that have long been spared from past

trade disputes due to the potential for harm to patients.

Trump excluded them from his announcement of sweeping import

tariffs last week, but in recent weeks he introduced tariffs on

raw ingredients and supplies from China that are used by the

industry, and has repeatedly singled out the manufacturing of

drugs in Europe as a problem he intends to tackle through a

tariffs announcement.

Tariffs could be "25% and higher", he has said. Here is what you

need to know:

WHAT IS TRUMP'S STANCE ON THE PHARMA INDUSTRY?

The Republican president has said major drugmakers such as Eli

Lilly ( LLY ), Johnson & Johnson ( JNJ ), and Pfizer ( PFE )

should manufacture more of their medicines for American patients

in the United States to lessen dependency on other countries and

increase tax revenue.

Many brand name drugs are made partly in Europe. Ireland,

with its low corporate tax rate, is a hub for production of the

active ingredients in blockbuster medicines, including Lilly's

weight-loss injection Zepbound and Merck's ( MRK ) huge-selling cancer

immunotherapy Keytruda.

Trump has also criticised U.S. pharma companies for registering

their intellectual property in Ireland because of the low

corporate tax rate.

In his tariffs announcement on April 2, Trump also said the

U.S. no longer produces enough antibiotics, which like most

generic drugs consumed by Americans are made in China and India.

Trump says it is unfair that the U.S. pays higher prices for

brand name drugs than other wealthy nations, in particular in

Europe.

"These other countries are smart," he said on Tuesday. "They

say you can't charge more than $88 otherwise you can't sell your

product and the drug companies listen to them."

The U.S. does not buy drugs directly for a national health

system, as countries such as England and Germany do, instead

relying on the private sector to manage drug price negotiations

for both government and private health plans. Last year, the

U.S. government began to directly negotiate prices for a limited

number of drugs used by the federal Medicare health program

under President Joe Biden's Inflation Reduction Act.

WHAT IS THE INDUSTRY'S RESPONSE?

Drugmakers have lobbied Trump to phase in tariffs on imported

pharmaceutical products to reduce the impact of the charges and

to gain time to shift manufacturing, sources told Reuters.

Several drugmakers, including Lilly, have announced plans to

increase manufacturing investments in the U.S. since Trump took

office. Novo Nordisk and others have cited ongoing efforts to

make more of their medicines for the U.S. market in the

country.

Trade group PhRMA says building a new production facility in

the U.S. can cost up to $2 billion and take 5 to 10 years before

it is operational, including time and cost to meet regulatory

requirements, backing up the industry argument for tariffs not

being levied immediately.

Some companies have also taken the unusual step of sending more

medicines by air from Europe to the U.S. to stockpile ahead of

possible tariffs.

WHEN COULD TRUMP ANNOUNCE PHARMA TARIFFS?

Trump's executive order last week listed pharmaceuticals

alongside lumber, semiconductors and other sectors that could be

subject to investigation under Section 232 of the 1962 U.S.

Trade Act to determine the effects of imports on U.S. national

security.

The investigation led by the Commerce Department must be

completed 270 days after it is announced.

The timing is not certain, but on April 8 Trump said that the

announcement on pharma tariffs would come "very shortly",

without referencing Section 232.

Creating further uncertainty, Trump on Wednesday said he would

temporarily lower new tariffs on many countries, even as he

raised them further on imports from China, in a sudden reversal

that sent U.S. stocks sharply higher.

WHAT WOULD BE THE IMPACT?

Industry executives and drug pricing experts say tariffs

increase the risk of shortages of widely used, cheap generic

medicines, such as antibiotics, which makers say they cannot

afford to continue producing with the added costs.

Tariffs could also eat into the margins of expensive brand

name pharmaceuticals and biotech medicines, and drugmakers say

that could leave them with less money to invest in research and

development for future medicines.