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prescription drugs
'Heinrich Should Be Ashamed': Lone Senate Dem Helps GOP Deliver Big Pharma Win
The provision, part of the Senate budget bill, was described as "a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients while draining $5 billion in taxpayer dollars."
Jul 01, 2025
The deep-pocketed and powerful pharmaceutical industry notched a significant victory on Monday when the Senate parliamentarian ruled that a bill described by critics as a handout to drug corporations can be included in the Republican reconciliation package, which could become law as soon as this week.
The legislation, titled the Optimizing Research Progress Hope and New (ORPHAN) Cures Act, would exempt drugs that treat more than one rare disease from Medicare's drug-price negotiation program, allowing pharmaceutical companies to charge exorbitant prices for life-saving medications in a purported effort to encourage innovation. (Medications developed to treat rare diseases are known as "orphan drugs.")
The consumer advocacy group Public Citizen observed that if the legislation were already in effect, Medicare "would have been barred from negotiating lower prices for important treatments like cancer drugs Imbruvica, Calquence, and Pomalyst."
Among the bill's leading supporters is Sen. Martin Heinrich (D-N.M.), whose spokesperson announced the parliamentarian's decision to allow the measure in the reconciliation package after previously advising that it be excluded. Heinrich is listed as the legislation's only co-sponsor in the Senate, alongside lead sponsor Sen. John Barrasso (R-Wyo.).
"Sen. Heinrich should be ashamed of prioritizing drug corporation profits over lower medicine prices for seniors and people with disabilities," Steve Knievel, access to medicines advocate at Public Citizen, said in a statement Monday. "Patients and consumers breathed a sigh of relief when the Senate parliamentarian stripped the proposal from Republicans' Big Ugly Betrayal, so it comes as a gut punch to hear that Sen. Heinrich welcomed the reversal and continued to champion a proposal that will transfer billions from taxpayers to Big Pharma."
"People across the country are demanding lower drug prices and for Medicare drug price negotiations to be expanded, not restricted," Knievel added. "Sen. Heinrich should apologize to his constituents and start listening to them instead of drug corporation lobbyists."
The Biotechnology Innovation Organization, a lobbying group whose members include pharmaceutical companies, has publicly endorsed and promoted the legislation, urging lawmakers to pass it "as soon as possible."
"This is a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients."
The nonpartisan Congressional Budget Office has estimated that the ORPHAN Cures Act would cost U.S. taxpayers around $5 billion over the next decade.
Merith Basey, executive director of Patients For Affordable Drugs Now, said that "patients are infuriated to see the Senate cave to Big Pharma by reviving the ORPHAN Cures Act at the eleventh hour."
"This is a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients while draining $5 billion in taxpayer dollars," said Basey. "We call on lawmakers to remove this unnecessary provision immediately and stand with an overwhelming majority of Americans who want the Medicare Negotiation program to go further. Medicare negotiation will deliver huge savings for seniors and taxpayers; this bill would undermine that progress."
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Report Exposes Big Pharma Front Groups Posing as Patient Advocates
"When your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
May 19, 2025
A report published Monday reveals that a number of organizations claiming to represent the interests of patients are actually pharmaceutical industry front groups working against efforts to bring down drug costs in the United States, including by lobbying the Trump administration to scale back Medicare price negotiations.
The new analysis by Patients for Affordable Drugs Now (P4AD), which stressed that it doesn't take money from organizations that profit from the production or distribution of prescription medications, spotlights six groups: the Alliance for Aging Research, the American Action Forum, the Center for Medicine in the Public Interest, the Council for Affordable Health Coverage, the Pacific Research Institute, and Seniors 4 Better Care.
The featured organizations, according to P4AD, "are posing as independent patient or policy groups while acting as mouthpieces for the drug industry's agenda—all while raking in pharma cash, fighting Medicare negotiation, and pushing misleading claims to block reforms."
Seniors 4 Better Care, for instance, is a shell group of the American Prosperity Alliance, the president of which "has a history of lobbying for the healthcare industry, including for organizations at the Healthcare Association of New York and insurance providers such as MVP Healthcare," P4AD's report observes.
"The group's treasurer, Parker Hamilton Poling, is a former lobbyist for pharmaceutical companies like Roche and Cencora," the report notes. "Brian Berry, the organization's secretary, also has a history of lobbying for Chinese biotech companies like Complete Genomics."
Earlier this year, Seniors 4 Better Care bankrolled an ad that directly urged President Donald Trump to end the "pill penalty," a label the pharmaceutical industry has used to describe the treatment of small-molecule prescription drugs under the Inflation Reduction Act's Medicare price negotiation provisions.
Last month, in a major gift to Big Pharma and industry lobbyists, Trump signed an executive order aimed at delaying Medicare negotiations for small-molecule drugs, which represent 90% of prescription medicines currently in circulation.
Another group highlighted in P4AD's report is the Center for Medicine in the Public Interest (CMPI), which describes itself as "a nonprofit, nonpartisan research and educational organization that seeks to advance the discussion and development of patient-centered healthcare."
P4AD notes that "every single member" of the organization's board has ties to the pharmaceutical industry. Peter Pitts, CMPI's president and co-founder, "primarily worked at firms hired by the pharmaceutical industry following an 18-month stint at the Food and Drug Administration," P4AD's report states.
"While working at major firms, such as Porter Novelli, Pitts retained his role at CMPI and insisted it was not a conflict of interest," the report continues. "He also currently teaches at the University of Paris, Descartes School of Medicine, a department that is funded by AstraZeneca."
Merith Basey, P4AD's executive director, said that "when your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
"Polling shows that Americans are aware that pharmaceutical corporations are the primary drivers of high drug prices, which is why the industry funds front groups to mislead the public and protect its bottom line," said Basey. "Patients and policymakers deserve to know whose interests these groups truly represent."
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FTC Report Shows Big Pharma Middlemen Jack Up Prices by Up to 7,736%
Pharmacy benefit managers "are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs."
Jan 14, 2025
The U.S. Federal Trade Commission on Tuesday published the second part of its investigation into how prescription drug middlemen are marking up the prices of specialty generic drugs dispensed at their affiliated pharmacies by hundreds—and in some cases, thousands—of percent, underscoring what advocates say is the need for urgent action by policymakers.
The FTC's second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health's Caremark Rx, Cigna Group's Express Scripts, and UnitedHealth Group's OptumRx—"marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually."
"Of the specialty generic drugs analyzed in this report and dispensed by the 'Big Three' PBMs' affiliated pharmacies for commercial health plan members between 2020 and 2022, 63% were reimbursed at rates marked up by more than 100% over their estimated acquisition cost... while 22% were marked up by more than 1,000%," the report states.
"For the pulmonary hypertension drug tadalafil (generic Adcirca), for example, pharmacies purchased the drug at an average of $27 in 2022, yet the Big Three PBMs marked up the drug by $2,079 and paid their affiliated pharmacies $2,106, on average, for a 30-day supply of the medication on commercial claims," the publication notes. That's a staggering average markup of 7,736%.
"The FTC's second interim report lays bare the blatant profiteering by PBM giants."
"Such significant markups allowed the Big Three PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs' estimated acquisition costs from 2017-22," the FTC said. "The Big Three PBMs netted such significant revenues all while patient, employer, and other healthcare plan sponsor payments for drugs steadily increased annually."
The new analysis follows a July 2024 report that revealed Big Three PBM-affiliated pharmacies received 68% of the dispensing revenue generated by specialty drugs in 2023, a 14% increase from 2016.
"The FTC staff's second interim report finds that the three major pharmacy benefit managers hiked costs for a wide range of lifesaving drugs, including medications to treat heart disease and cancer," FTC Chair Lina Khan said in a statement Tuesday. "The FTC should keep using its tools to investigate practices that may inflate drug costs, squeeze independent pharmacies, and deprive Americans of affordable, accessible healthcare—and should act swiftly to stop any illegal conduct."
Khan's time as chair is limited. Republican U.S. President-elect Donald Trump's inauguration is next week and he has named Andrew Ferguson as the next FTC chair. As Ferguson is already on the commission, his elevation to chair won't require Senate confirmation.
Greg Lopes, spokesperson for the Pharmaceutical Care Management Association, a PBM lobby group, said Tuesday that "it's clear this report again fails to consider the entirety of the prescription drug supply chain and makes sweeping assertions about the role of PBMs disconnected from a full appreciation of their critical cost-saving role for employers, unions, taxpayers, and patients."
Last September, the FTC sued the Big Three and their affiliated group purchasing organizations for allegedly "engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs, impaired patients' access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients."
FTC Office of Policy Planning Director Hannah Garden-Monheit said Tuesday that the problem of PBM price inflation "is growing at an alarming rate, which means there is an urgent need for policymakers to address it."
To that end, U.S. Sens. Maria Cantwell (D-Wash.) and Chuck Grassley (R-Iowa) introduced the Pharmacy Benefit Manager Transparency Act of 2023, a bill backed by the AARP aimed at increasing transparency and "holding PBMs accountable for deceptive and unfair practices that drive up prescription drug costs and force independent pharmacies out of business."
"This report is a call to action for policymakers to dismantle these exploitative schemes."
Responding to the FTC report, Emma Freer, senior policy analyst for healthcare at the American Economic Liberties Project—a corporate accountability and antitrust advocacy group—said in a statement Tuesday that "the FTC's second interim report lays bare the blatant profiteering by PBM giants, which are marking up lifesaving drugs like cancer, HIV, and multiple sclerosis treatments by thousands of percent and forcing patients to pay the price."
"By steering prescriptions for the most expensive specialty generic drugs to their own pharmacies, PBMs are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs," Freer added. "This report is a call to action for policymakers to dismantle these exploitative schemes, outlaw the rebate system driving up prices, and restore fairness and affordability to the U.S. healthcare system."
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