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Lobbyists working to pass Pharma-backed legislation currently outnumber lobbyists working to oppose it by more than 20-to-1, estimates Public Citizen.
Government watchdog Public Citizen is warning that the pharmaceutical industry is preparing an all-out blitz aimed at sabotaging government efforts to negotiate lower prices for prescription drugs.
In a report released on Wednesday, Public Citizen said it found that the major pharmaceutical companies this year have hired more than 500 lobbyists to push for the passage of three pieces of legislation that would undermine the provisions allowing the government to negotiate lower drug prices contained in the 2022 Inflation Reduction Act.
The first piece, called the ORPHAN Cures Act, was passed by Congress in July after being stuffed into the One Big Beautiful Bill Act. According to Public Citizen, the law will "delay and exempt some of the most profitable drugs—including cancer treatments—from negotiations, representing tens of billions in annual Medicare spending."
The other two pieces of legislation—the EPIC Act and the MINI Act—have not yet been passed, and Public Citizen says that they "would lengthen the already long delay period before small molecule drugs are eligible for negotiation—effectively excluding many medicines from negotiations entirely or shortening the period patients have access to lower negotiated prices to only one or two years."
Public Citizen estimates that there are currently 501 lobbyists who are pushing to pass these laws, while just 24 lobbyists are working to block their passage. In total, notes Public Citizen, this means opponents of the legislation are outnumbered by a ratio of more than 20-to-1.
Steve Knievel, Public Citizen's access to medicines advocate, called on elected representatives to "reject the demands of pharma lobbyists and instead work to make prescription drugs more affordable" for their constituents.
"Instead of handing drug corporations billions of dollars by helping them evade price negotiations," Knievel said, "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."
"Donald Trump and Republicans are selling out America's seniors," said one advocate.
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."
"Unlike Trump, I believe we need more than just press releases, polite requests to drug companies, and pilot projects," the senator said.
As President Donald Trump's deadline for large drugmakers to make "binding commitments" to cut prices expired on Monday, Sen. Bernie Sanders released a report showing that the cost of hundreds of prescriptions has risen in the United States since the Republican returned to office in January.
In response to the president's May executive order and July letters giving drugmakers 60 days to act, Sanders (I-Vt.), ranking member of the Senate Health, Education, Labor, and Pensions Committee, "directed his staff to examine prescription drug prices," explains the report, The Art of the Bad Deal: Trump's Failure to Lower Prescription Drug Prices.
The committee staffers documented price increases for 688 medications—310 brand-name drugs and 378 generic ones—during Trump's second term, with a median increase of 5.5% and 25 treatments more than doubling in cost.
"Of the 17 companies that received a letter from President Trump on July 31, 2025, 15 raised the price of at least one product since Trump took office," the report notes. "Since Trump sent letters asking drug companies to lower prices, the prices of 87 drugs have increased."

Overall, the highest hike was 1,555%. Eton Pharmaceuticals increased the price of Galzin, which is used to treat a rare genetic liver disorder called Wilson's disease, from $5,400 to $88,800 per year in the United States—even though it only costs $1,400 in the United Kingdom and $2,800 in Germany.
The report highlights some other examples, such as Novartis' cancer drug Kymriah, which increased by $25,600, or 4.5%, to $594,000 annually. In the UK, it costs $381,000 a year, and in Germany it's $282,000. The report also notes the company's executive compensation last year: $83.3 million.
Vertex jacked up the price of Trikafta, used to treat cystic fibrosis, by 7%, or $23,900, to $365,000 a year, according to the report. Just north of the US, in Canada, it's only $146,000. The company's executive compensation for 2024 was $12.7 million.
Johnson & Johnson increased the price of Xarelto, used to treat and prevent blood clots, by 5% to $7,200—far higher than its cost in Canada ($750), the UK ($880), and Germany ($1,300). The company also hiked the price of Spravato, a nasal spray used to treat depression, by 8% to $28,100, roughly double the cost in those other three countries. Its executive compensation was $64.5 million.
"These price increases are just the beginning. Trump's chaotic across-the-board tariffs will further increase prices," the report warns. "Trump has already imposed a 15% tariff on pharmaceutical products from Europe and Japan, and he has threatened to increase tariffs on pharmaceuticals to up to 250%."
"On September 25, Trump announced that he will impose a 100% tariff on pharmaceutical products starting October 1 unless a product's manufacturer is making or is planning to make the product in the US," the publication details. "Insurers are already reporting that higher drug prices arising from tariffs will result in higher health insurance premiums."
The report continues:
In addition, instead of working with Congress to pass legislation to lower prescription drug prices, the Trump administration spent its first months in office racing to sign a law that makes the largest federal healthcare cuts in history. The cuts will make it harder for millions of Americans to afford prescription drugs as people lose coverage and face ballooning premium bills and rising out-of-pocket costs. In addition, hidden in the administration's One Big Beautiful Bill Act is a multibillion-dollar giveaway to some of the largest pharmaceutical companies in the world.
OBBBA prevents or delays Medicare from negotiating the price of some of the most expensive prescription drugs. Public reporting and analyses have identified several drugs that will benefit from this loophole.
The document stresses that "any real solution to lowering prescription drug prices will require legislation, not just press releases," and points to Sanders' Prescription Drug Price Relief Act, which "would ensure Americans do not pay more for prescription drugs than the median price paid in Canada, the United Kingdom, France, Germany, and Japan."
Although Trump's health and human services secretary, Robert F. Kennedy Jr., "committed to working with Sen. Sanders on this legislation at a hearing in May 2025, HHS stopped responding to staff-level requests to work together to get this bill passed into law after one meeting," according to the report.
Echoing the report, Sanders said in a Monday statement that "I agree with President Trump: It is an outrage that the American people pay, by far, the highest prices in the world for prescription drugs. But unlike Trump, I believe we need more than just press releases, polite requests to drug companies, and pilot projects. We need real action to take on the greed of the pharmaceutical industry and substantially reduce the cost of prescription drugs for all Americans."
"If President Trump is serious about making real change, he will support my legislation to make sure Americans pay no more than people in other major countries for the exact same prescription drug," added Sanders, a longtime advocate of Medicare for All. "Now is the time to end the greed of the pharmaceutical industry."