How Trump's Greenland demands could impact Ozempic costs

President-elect Trump's threat to tariff Denmark if it resists his acquisition plans for the island territory of Greenland could disrupt one export that is wildly popular in America: Ozempic.

Trump added Denmark to his growing list of tariff targets — including Canada, Mexico and China — as he has increasingly spoken of the U.S. taking Greenland off Denmark's hands.

Danish multinational pharmaceutical giant Novo Nordisk is the sole owner of semaglutide, the active ingredient in both Ozempic and Wegovy. A month’s supply of Ozempic is close to $1,000 without insurance, though manufacturer coupons and patient assistance programs are available.

Novo Nordisk was estimated to be responsible for half of Denmark’s gross domestic product growth in 2024.

According to census data available through November, pharmaceutical products accounted for roughly 30 percent of Danish imports coming in through U.S. ports in 2024.

Polling from KFF last year found that 1 in 8 U.S. adults said they’ve tried a GLP-1 drug like Ozempic, including nearly half of those with diabetes and a quarter of people with heart disease.

When reached for comment, a Novo Nordisk spokesperson would not address the tariff threat directly: “We will follow the situation closely; however, we will not comment on hypotheticals and speculations. The geopolitical landscape in today’s world is very dynamic, and we remain focused on our commitment to deliver lifesaving medicines to the patients we serve.”

Medical supply chain experts have previously said Trump’s proposed tariffs would likely cause the price of imported drugs to go up. Still, there are several factors at play when it comes to semaglutide access in the face of the president-elect's threats.

How serious is Trump?

The incoming administration will have broad authority to enact tariffs and would be able to structure them as specifically as they wish. But some trade experts are dubious that tariffs against Denmark will ever materialize.

“We do not know if this current Greenland obsession is distraction-generation or anything real,” said Lori Wallach, director of the Rethink Trade program at American Economic Liberties Project.

“Even if there is something to it, he would need to have a legal basis to impose tariffs,” Wallach added. “And depending on what law he uses, and I am hard-pressed to imagine what would work, it could take time.”

But it wouldn’t be the first time Trump has imposed tariffs on European allies.

During his first term, Trump enacted levies on European steel and aluminum imports, claiming they threatened national security. Trump has similarly cited security concerns as a reason for his interest in Greenland. President Biden suspended these tariffs in 2021 as part of an agreement with the European Union.

“Things done in the name of national security have broad latitude. And while there could be immediate retaliation by the European Union, there could be other actions that are taken in the courts in the United States and elsewhere,” Penny Naas, a distinguished scholar at the German Marshall Fund, told The Hill.

Given the popularity and demand for semaglutide products, as well as medical devices that also originate from Denmark such as hearing aids, Naas notes there would be "tradeoffs" the Trump administration would need to consider in tariffs against Denmark.

How specific can a tariff be?

The White House can make tariffs as targeted as it wants.

Novo Nordisk is a multinational corporation with facilities across the globe, including six in the U.S. The company has a facility in Clayton, N.C., where it fills and packages most injectable obesity products used by patients in the U.S.

Giving the example of a sweater imported from Europe, Naas explained tariffs can be as precise as “the material it's made from, if it's for a man or a woman or for children. It can be broken down even further if there's some kind of embellishment on it. So, you can break down goods to a very minute level, and you can be very surgical and strategic.”

According to Mark Hendrickson, director of supply chain policy at the health care improvement company Premier Inc., tariffs can consider numerous factors when it comes to imported pharmaceutical products.

"Are we just talking about products coming physically from Denmark into the United States? Or, specifically, is it what products owned by, in this case, Novo? Where are they coming from? They have facilities all over the world, including Brazil, China, France and then some local sites in the United States as well,” said Hendrickson.

Regardless of how a tariff is ultimately structured, Hendrickson surmises that Novo Nordisk would need to rethink how it gets products into the U.S., especially given how big of a market it is for the company.

There are international agreements that could also save Ozempic from being subject to tariffs.

The 1994 Agreement on Trade in Pharmaceutical Products under the World Trade Organization calls for the elimination of tariffs and customs duties on pharmaceutical products and the substances used to make them. The U.S. is among the signatories to this agreement.

The agreement was last updated in 2011 and includes more than 10,000 products.

Compounded versions still around

Semaglutide was declared to be in shortage more than two years ago by the Food and Drug Administration (FDA), and, in that time, compounding pharmacies have been able to sell compounded versions of the drug at much lower prices.

Even though the FDA found Ozempic and Wegovy to be “Available” in October, the agency has yet to remove these products from its drug shortage list.

When reached for comment on when Ozempic and Wegovy may come off the shortage list, an FDA spokesperson said the agency “cannot provide a general timeline for when a drug may come off the shortage list because each drug shortage is assessed on a case-by-case basis.”

“The FDA continues to actively monitor drug availability and is currently working to determine whether the demand or projected demand for semaglutide within the U.S. exceeds the available supply,” they added.

As compounded medicines are made in the U.S. by compounding pharmacies, a tariff-induced hike in the price of Ozempic may drive patients to turn to these domestic sources.

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