Trump-GOP Giveaway to Big Pharma Will Hit Taxpayers With $9 Billion in Higher Drug Costs

A major pharmaceutical industry handout that Republicans—with the support of one Senate Democrat—included in President Donald Trump's signature legislative package is expected to cost US taxpayers nearly twice as much as originally expected, the nonpartisan Congressional Budget Office said in an updated analysis released Monday.

The CBO initially projected that the provision, known as the ORPHAN Cures Act, would cost around $5 billion over the next decade. But the office said Monday that its earlier assessment did not take into account several major, high-priced drugs that will be exempted from Medicare price negotiations as a result of the Trump-GOP law.

The budget office said it now expects the provision of Trump's One Big Beautiful Bill Act to cost $8.8 billion over the next 10 years.

Among the drugs included in the new CBO analysis is Keytruda, a cancer medication sold by Merck that carries a list price of $24,062 every six weeks. The Trump GOP-budget law delays Keytruda's eligibility for Medicare price negotiations by at least a year, postponing significant potential savings for taxpayers and patients.

Merith Basey, executive director of Patients for Affordable Drugs Now, said in response to the updated CBO analysis that "the ORPHAN Cures Act is a wildly expensive handout to Big Pharma that will harm patients, drain taxpayer dollars, and weaken the government's ability to rein in high drug prices."

Basey noted that the "insatiable" pharmaceutical industry is not satisfied with the enactment of the ORPHAN Cures Act, which restricts Medicare price negotiations for drugs that treat more than one rare disease. Big Pharma, Basey said, is "spending record sums this year to advance additional carveouts like the EPIC Act, which would exempt even more blockbuster drugs from negotiation."

"Any support for these bills goes against the will of the 90% of Americans who want Congress to go further to lower drug prices—not facilitate another handout to Big Pharma," said Basey.

"This isn't about helping lower costs—it's about doing the bidding of big drug companies, and Trump and the GOP are all too happy to oblige."

The deep-pocketed pharmaceutical industry has waged war on the popular Medicare price negotiation program since its inception during the Biden administration.

While pharmaceutical giants' efforts to gut the program have been stymied in court, the industry-friendly Trump administration and Republican lawmakers have done pharma's bidding through legislation and executive action. Earlier this year, as Common Dreams reported, Trump signed an executive order aimed at delaying price negotiations for a broad category of medications despite the president's repeated promises to bring down costs.

"Trump and Republicans are selling out America's seniors," said Brad Woodhouse, president of the advocacy group Protect Our Care. "Instead of letting Medicare negotiate lower prices for more drugs, they carved out a loophole to protect the industry's most profitable drugs."

"Not only does the GOP tax bill throw over 15 million Americans off their healthcare and hike costs for millions more, but it also forces older Americans to pay more for life-saving medicines while CEOs and billionaires line their pockets with more money than they know what to do with," Woodhouse continued. "This isn't about helping lower costs—it's about doing the bidding of big drug companies, and Trump and the GOP are all too happy to oblige."

Steve Knievel, access to medicines advocate at Public Citizen, said Monday that "instead of transferring $10 billion from taxpayers and cancer patients to drug corporations that are already extremely profitable, President Trump and members of Congress must work to strengthen and expand Medicare drug price negotiations."

"Instead of gutting the law through bills like the ORPHAN Cures Act, EPIC Act, and MINI Act so Big Pharma can block negotiations on blockbuster treatments," Knievel added, "Congress should pass legislation to empower Medicare to negotiate lower drug prices on all costly medicines and allow all patients to access lower, negotiated prices, even if they don't have Medicare."