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"You owe the American public an explanation for why you took part in PhRMA's influence-peddling events with President Trump," wrote Sens. Elizabeth Warren, Ron Wyden, and Bernie Sanders.
A group of progressive U.S. senators on Monday pushed Robert F. Kennedy Jr., secretary of the Health and Human Services Department, to disclose what he and President Donald Trump discussed with pharmaceutical executives at recent private dinners as the industry pressures the new administration to end Medicare drug price negotiations.
In a letter to Kennedy, Sens. Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.), and Bernie Sanders (I-Vt.) pointed to Wall Street Journal reporting from last month on the millions of dollars that healthcare industry executives spent to dine with Trump at his Mar-a-Lago club in Florida ahead of his inauguration.
Kennedy, according to the Journal, "attended several of the dinners, but largely stayed quiet as Trump and others talked."
Warren, Wyden, and Sanders wrote to Kennedy that "the dinners may have served as an opportunity for Big Pharma to gain insider access to both you and President Trump" and asked the HHS chief to reveal information about the meetings with industry executives, including how many there have been since the November election and whether Medicare drug price negotiations or other critical matters were discussed.
"Big Pharma stands to profit immensely from a second Trump administration, especially if they can convince you and President Trump to abandon policies like Medicare drug price negotiations and patent reform that would save Americans hundreds of billions of dollars on lifesaving drugs," the senators wrote. "Indeed, the executives that attended these dinners have called on him to 'pause drug negotiations'—negotiations that are expected to save taxpayers $100 billion by 2032."
"You owe the American public an explanation for why you took part in PhRMA's influence-peddling events with President Trump, what happened at these meetings, and whether they will affect your commitment to ensuring that Americans receive the relief they deserve from high drug prices," the senators added.
RFK Jr. said he'd "clean up corruption" as HHS Secretary. So why'd he have dinner with Big Pharma executives at Mar-a-Lago with Trump? The American people deserve to know what kind of deals might have been made at those "million-dollar" dinners.
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— Elizabeth Warren (@warren.senate.gov) March 10, 2025 at 7:29 PM
The Journal reported that the CEO of Pfizer, which pumped $1 million into Trump's inaugural committee, was among the executives who attended the private Mar-a-Lago dinners. Eli Lilly's chief executive also joined at least one of the dinners.
Though Kennedy, an anti-vaccine conspiracy theorist, has vocally criticized Big Pharma and its political influence, the industry did not lobby against his nomination to lead HHS, which oversees the Medicare drug price negotiations that began during the Biden administration.
Last month, the head of the pharmaceutical industry's biggest lobbying group and several pharma CEOs met with Trump as part of a campaign to weaken the price negotiations, which threaten drugmakers' ability to jack up prices at will.
The negotiations have yielded significant results, but Trump's Centers for Medicare and Medicaid Services—an agency within HHS—has signaled it is open to altering the program.
"The Trump administration's statement is far from an embrace of drug price negotiation," Wyden and other senators warned earlier this year, "and appears to be opening the door to changes that could undermine Medicare's ability to get the best price possible on drugs."
Since 2020, 21 drug companies have restricted the number of contract pharmacies where 340B nonprofits can fill patient prescriptions. Their attack undermines the intent of the 340B statute.
Drug companies keep making excuses for why they do not have to live up to their 340B statutory obligations. Since 2020, 21 drug companies have restricted the number of contract pharmacies where 340B nonprofits can fill patient prescriptions. Their attack undermines the intent of the 340B statute.
Drug companies insist they have legitimate oversight concerns, yet their supposed good governance concerns belie the pharmaceutical industry’s true intent. Simply stated, drug makers want to extract every dollar they can from their products, even if it means breaking an agreement with the federal government to sell a tiny percentage of their drugs at a discount to the nonprofits that reinforce America’s healthcare safety net.
Healthcare nonprofits rely on 340B drug discount savings to care for the most vulnerable Americans. For patients to access life-saving medicines, they must be able to pick up their prescriptions from community pharmacies. Many low-income, uninsured Americans lack the time and resources to travel far from their work and homes—often passing by multiple pharmacies—to a single drug company-approved prescription drug dispensing site. The 2010 Affordable Care Act (ACA) recognized that problem, empowering the Health Resources and Services Administration (HRSA) to promote medication access through contract pharmacy use. Federal guidelines wisely allow nonprofits to engage in multiple contract pharmacy agreements.
Simply stated, drug makers want to extract every dollar they can from their products, even if it means breaking an agreement with the federal government to sell a tiny percentage of their drugs at a discount to the nonprofits that reinforce America’s healthcare safety net.
So why did drug companies wait until 2020—10 years after the HRSA guidelines went into effect—to begin enacting contract pharmacy restrictions? The answer is simple. Just one year earlier, in 2019, a little-known ACA provision which requires drug makers to submit drug pricing information to a database finally came online. The “ceiling price” database provides nonprofits with the requisite data to ensure drug companies do not charge above the 340B ceiling price. Companies that overcharge are subject to a civil monetary penalty. The 340B statute requires those companies to then sell the offending drug at just one penny in the next calendar quarter.
Data transparency shows that drug companies have broken the law, frequently overcharging healthcare nonprofits for prescription drugs. The pre- and post-ceiling price data reveal a stark contrast in how often HRSA uncovered drug company malfeasance. From 2015 to 2018, only 6% of HRSA audits uncovered instances of drug company overcharging. After January 1, 2019—when mandatory drug company database reporting began—audits found overcharging in 67% of cases. In 2021 alone, 80% of audits revealed drug company overcharges.
Take Eli Lilly as just one example. In December 2022, the drug maker announced refunds for 340B overcharges for the fifth time that year. It is no coincidence that restrictions began apace with the advent of the ceiling price database.
Essentially, drug companies had no issue with nonprofits using multiple contract pharmacies when they could get away with rampant overcharging. And why would they? Without the government watching, multiple dispensing sites afforded drug companies more opportunities to overcharge nonprofits. Drug companies got away with nearly a decade of overcharges, with no recourse for nonprofits. Now, the same companies that ran wild when the government was not watching, decry the lack of federal oversight when it comes to nonprofit contract pharmacy use.
For the record, 340B nonprofits are subject to audit by the federal government and drug makers. Failure to comply removes a nonprofit provider from the 340B program.
Contract pharmacy restrictions couched as best practices represent a cynical ploy by drug companies. Drug companies caterwaul that oversight lapses result in double-charges for 340B discounts, once by nonprofits and once by state Medicaid agencies.
Simply saying something does not make it true. HRSA conducted 638 hospital audits since 2018 to ensure Medicaid fee-for-service compliance rules, and not one 340B contract pharmacy duplicate discount occurred. Drug companies want to be able to raise list prices year-over-year without 340B statutory penalties, and, now that a federal agency is watching, program obligations threaten the bottom line. Drug makers now consider 340B discounts as financial exposure to be avoided at all costs.
Ignore drug industry duplicity when it comes to 340B. Drug companies have repeatedly acted in bad faith, finding any loophole possible to abrogate statutory obligations.
If drug companies no longer wish to participate in 340B, they can leave the program and no longer sell their products to Medicaid and Medicare. Perhaps that is a deal they can finally honor.
On Friday, Sen. Bernie Sanders (I-Vt.) said he would vote against President Barack Obama's nomination to head up the Food and Drug Administration (FDA), citing Dr. Robert M. Califf's ties to the pharmaceutical industry.
Califf, a cardiologist, and Duke University researcher became FDA deputy commissioner earlier this year, and Obama announced plans to nominate him as the agency's chief last month. But in light of several recent industry scandals that brought national attention to price gouging of life-saving medications, Sanders--who is running for president as a Democrat--said he would not support the status quo when the vote comes before the U.S. Senate health committee.

"At a time when millions of Americans cannot afford to purchase the prescription drugs they need, we need a new leader at the FDA who is prepared to stand up to the pharmaceutical companies and work to substantially lower drug prices. Unfortunately, I have concluded that Dr. Califf is not that person," Sanders said following a meeting with the nominee this week.
A recent expose by the New York Times revealed that Califf's multi-million dollar research center at Duke received more than 60 percent of its funding from the industry. At the same time, his 2014 financial disclosure documents showed drug companies like Eli Lilly, Merck, and Novartis paid him hefty fees for "consulting" and in salary support. And as the Boston Globe reported on Wednesday, Califf also took the "highly unusual" step of removing his name from a series of scientific papers criticizing the FDA's oversight of clinical trials--"a decision that could raise ethical concerns," explains the Globe's Sheila Kaplan.
"In a sense, he's the ultimate industry insider," Harvard political science professor Daniel Carpenter told the Times.
Sanders continued on Friday, "Instead of listening to the demands of the pharmaceutical industry and their 1,400 lobbyists, it is about time that the FDA and Congress started listening to the overwhelming majority of the American people who believe that medicine is too expensive."
"It is time for the United States to join the rest of the industrialized world by implementing prescription drug policies that work for everybody, not just the CEOs of the pharmaceutical industry," he said.
Given the recent price-gouging cases, both Sanders and Democratic frontrunner Hillary Clinton have made reform of the pharmaceutical industry central platforms of their campaigns. For his part, Sanders recently introduced a plan allowing Medicare to negotiate drug prices with manufacturers and lower barriers to importing cheap pharmaceuticals from other countries, such as Canada.
"The greed of the pharmaceutical industry is a public health hazard to the American people," Sanders said. "That has got to change."