Germany’s tougher stance on drug pricing and the new U.S. Section 301 investigation into those policies have turned the spotlight onto where medicines are actually made and how exposed each stock might be to trade friction. For U.S. investors, this creates a fresh filter for thinking about domestic pharmaceutical manufacturers that could be helped or hurt as global pricing and tariff risks evolve. This article walks through three U.S. drug manufacturing stocks that appear positioned on the positive side of this news and explains why their exposure to the investigation matters for your portfolio decisions.

Ionis Pharmaceuticals (IONS)

Overview: Ionis Pharmaceuticals is a commercial-stage biotech based in Carlsbad, California that develops RNA-targeted medicines for serious rare and genetic diseases, including treatments for spinal muscular atrophy, hereditary amyloidosis, familial chylomicronemia syndrome, hereditary angioedema and amyotrophic lateral sclerosis.

Operations: Ionis Pharmaceuticals generates US$1.1b in revenue from its Ionis Operations segment.

Market Cap: US$12.2b

Ionis Pharmaceuticals sits at the center of the US domestic manufacturing theme, with RNA-based drugs developed and largely produced in the US and a growing portfolio of commercial products supported by large pharma partners like Biogen, AstraZeneca, Novartis and Roche. Investors get exposure to multiple late-stage catalysts, including priority FDA reviews for olezarsen, zilganersen and bepirovirsen, alongside improving losses and higher 2026 revenue guidance. However, that comes with execution and pricing risk as Ionis moves from rare diseases into broader populations where payors are tougher. At the same time, management highlights supply-chain redundancies and limited tariff impact so far, which could matter if trade friction around German drug imports escalates.

Ionis Pharmaceuticals looks like an RNA powerhouse with US based manufacturing, late stage catalysts and big pharma partners, but the real story sits in the analyst forecasts for Ionis Pharmaceuticals that could reshape how investors see its risk profile.

Repligen (RGEN)

Overview: Repligen is a life sciences company that supplies the tools and systems used to make biologic drugs, selling filtration devices, chromatography columns, protein A ligands, process analytics and other consumables that biopharma companies and contract manufacturers rely on throughout drug development and production.

Operations: Repligen generates about US$763.3m in revenue from Medical Products, serving biopharmaceutical, life sciences and diagnostics customers across North America, Europe and the Asia Pacific.

Market Cap: US$7.4b

Repligen sits at an interesting crossroads for this US Domestic Pharmaceutical Manufacturers theme because it makes the “picks and shovels” that support biologic drug production rather than the drugs themselves. With over 90% of US revenue produced in US facilities and management aiming for dual manufacturing across the portfolio, the company aligns with a supply chain resilience focus that can matter more as trade tensions around Europe and German drug pricing rise. At the same time, the stock carries a very high P/E, relies heavily on externally funded biotech customers and has seen insider selling, so investors are paying up and taking on funding and product mix risk. The contrast between those trade-resilient assets and the richer valuation plus customer exposure is what makes Repligen a subject for closer examination.

Repligen’s rich P/E and US focused production raise a key question: are investors paying for resilience or missing what the 4 key rewards and 1 important warning sign is really signaling about where the story could turn next

Mirum Pharmaceuticals (MIRM)

Overview: Mirum Pharmaceuticals is a US biopharma company that develops and sells treatments for rare liver and metabolic diseases, led by LIVMARLI for cholestatic pruritus in Alagille syndrome and supported by Cholbam and Chenodal for bile acid disorders and gallbladder stones. It is also advancing earlier stage programs for conditions like cholestatic liver disease, chronic hepatitis D and Fragile X syndrome.

Operations: Mirum Pharmaceuticals generates about US$569.6m in revenue from pharmaceuticals, with roughly US$442.6m coming from the United States and US$127.1m from the rest of the world.

Market Cap: US$6.5b

Mirum Pharmaceuticals stands out in the US Domestic Pharmaceutical Manufacturers theme because its rare disease drugs are produced in the US while its commercial opportunity is increasingly global, including LIVMARLI launches and reimbursement negotiations in Germany and other European markets that are now under pricing scrutiny. That combination gives Mirum exposure to potential changes in relative attractiveness if tariffs or pricing disputes affect imported therapies. It still faces meaningful risks, including ongoing losses, a short cash runway and heavy dependence on LIVMARLI as the primary revenue driver. For investors, the focus is on how its rare disease portfolio, late stage pipeline and international expansion might interact with those financing and concentration risks as the Section 301 investigation keeps attention on where critical medicines are manufactured.

Mirum Pharmaceuticals is shaping up as a rare disease story with US based manufacturing and a global rollout that many investors might be underestimating. The real tension between its cash runway, LIVMARLI reliance and upside potential sits inside the 3 key rewards and 2 important warning signs (1 is major!)

These three stocks are only a starting point. The full US Domestic Pharmaceutical Manufacturers screener surfaces 7 more US based manufacturers with equally compelling narratives around pricing pressure, trade friction and domestic production. Use Simply Wall St to identify, analyze and filter for the specific catalysts and storylines that matter to you so you can focus on the highest conviction ideas within this theme.

Take Control of Your Investment Journey

If Ionis Pharmaceuticals or any of these companies sound like a great opportunity, register for FREE with Simply Wall St and add your companies to a Watchlist to monitor the share price against the fair value the ideal entry point. Once you've made your move, manage your holdings with our Portfolio Command Center that filters out the noise to deliver only the most critical, actionable updates. Throughout your journey, our Community allows you to filter the best ideas from thousands of investor perspectives. By uncovering hidden catalysts and risks early, you'll accelerate your decision-making and stay one step ahead of the market.

Seeking Fresh Alternatives Beyond These Stocks?

Fresh ideas do not stay under the radar for long. If you want momentum before prices start flying or dropping on headlines, scan these curated lists and get in early.

• Spot potential turnaround stories early by reviewing 19 high quality undiscovered gems that are still under the radar for now but could attract attention once the crowd catches up.
• Explore infrastructure-related ideas by checking out 34 power grid technology and infrastructure stocks as companies tied to grid upgrades and electrification move from quiet groundwork to more visible activity.
• Strengthen your core holdings with the list of solid balance sheet and fundamentals (48 results) so you are not caught holding weaker balance sheets if sentiment suddenly shifts against more fragile businesses.

This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.