As the Trump administration prepares to implement a 100% tariff on brand-name prescription drugs beginning Wednesday, Colorado pharmacists fear the move could significantly disrupt their operations and patient care. Capitol Heights Pharmacy is a fixture in the Congress Park neighborhood of Denver. Owner and pharmacist Kristin Holmes said the looming policy change has generated uncertainty that can be especially challenging to navigate for small businesses. "My biggest question is what does this mean for pharmacies? What does this mean for our purchasing?" said Holmes. "We can't incur costs that just double overnight." The new tariff is aimed at brand-name medications imported from outside the U.S. Only companies building pharmaceutical manufacturing plants on American soil are expected to be exempt. So far, there has been no mention of tariffs on generic pharmaceuticals. According to Holmes, pharmacies must pay for medication up front before receiving reimbursement from insurance companies — a process that often takes four to eight weeks. For small operations, that delay creates a precarious financial burden that rising drug costs could worsen. "When we're talking thousands of prescriptions and tens of thousands of dollars, if you're not paid back in a timely fashion, there's no way to recover from that," she offered. "I don't think any of us have a great idea of how it will be implemented or how it will work." The Colorado Pharmacists Society echoed those concerns, warning that pharmacies already operate on razor-thin margins. "Oftentimes, the budget for their pharmaceuticals is set and they know what they can spend," said CEO Emily Zadvorny. Despite the challenges, Holmes is trying to stay hopeful but realistic. "We're like most Americans, we'll see what happens when it happens," she said.