The pharmaceutical sector is a huge part of the Irish economy, providing thousands of well-paid jobs and contributing billions of euro in Corporation tax.
The Government has warned that exports of pharmaceuticals and chemicals from Ireland to the United States could decline by about half if the Trump administration applies a 20% tariff on the sector and the EU retaliates.
That would result in a massive blow to the economy.
There are more than 90 pharmaceutical companies located throughout the country, employing around 50,000 people.
Around 30,000 of those workers are employed by US companies at plants located throughout Ireland.
It is estimated that a further 50,000 jobs are supported by the pharma sector.
Pharma is a significant employer in the midlands and west, and most of the big firms here have bases in Dublin.
There is a big pharmaceutical cluster in Cork, where companies such as Pfizer, Merck, Johnson and Johnson, Lilly and AbbVie all have major operations.
Pat Dineen is a pharma worker based in Cork and is an activist with the SIPTU trade union.
He said there are worries among staff about what US tariffs might mean for the industry.
"There is a concern, probably more in the medium term, regarding how the big corporations might relocate," Mr Dineen said.
"This is not a plea or anything, but I think it would be sensible for the corporations to look at the huge benefits they have accrued from being here in Ireland."
"The workers and the whole economy have also benefited hugely from the companies being here," he added.
Exports of medical and pharmaceutical products rose to €99.9 billion last year and Ireland is now the world's third largest exporter of pharmaceuticals.
Companies are anxiously waiting to see what US tariffs, and the EU response, might mean for their operations.
"It is concerning to companies," said Oliver O’ Connor, Chief Executive of the Irish Pharmaceutical Healthcare Association.
"They will have to absorb a lot of costs because it's very difficult to pass that on to customers, to patients in the United States, so any extra cost of 25% or more coming in on a business is extremely difficult to absorb for any length of time."
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"So they will be looking at how they use their plants in Ireland to serve the needs of patients."
"This recalibration issue is on the agenda and we have to see over the coming years how this all plays out," Mr O'Connor said.
No one is forecasting immediate plant closures or job cuts due to tariffs, but there are concerns over the long-term pain if there is a slowdown in future pharma investments.
