Big Pharma Lobbies to Erode Landmark Drug Pricing Reform
Public Citizen News / Nov-Dec 2025
By Megan Whiteman
This article appeared in the November/December 2025 edition of Public Citizen News. Download the full edition here.
Big Pharma is pulling out all the stops to kill the most impactful drug pricing reform in decades. The Medicare Drug Price Negotiation Program, established by the 2022 Inflation Reduction Act, empowered Medicare to directly negotiate drug prices with pharmaceutical companies. The program is projected to save billions of dollars for Medicare and lower costs for millions of Americans, with the first round of negotiated drug prices alone estimated to save $1.5 billion for Medicare beneficiaries and $6 billion for taxpayers.
Big Pharma has filed a slew of lawsuits to derail price negotiations, but the courts have thus far rejected the industry’s court challenges. Public Citizen filed amicus briefs in the cases on behalf of consumer and health groups in support of the negotiation program.
Big Pharma doesn’t easily take no (or “lessen your price gouging”) for an answer, and the industry and its allies in Congress and the White House are pushing legislation that threatens to undermine the negotiation program’s ability to deliver savings to taxpayers and Medicare patients.
A recent Public Citizen analysis shines a light on how Big Pharma has dispatched hundreds of lobbyists to defang Medicare price negotiation. We examined lobbying activity during the first half of 2025 on three bills that would either delay negotiations on certain drugs or exempt some drugs entirely. Some key findings include:
- There were 515 unique lobbyist-client relationships, wherein a client (a company, trade group, or nonprofit organization) hired an individual to lobby on at least one of three bills that would weaken Medicare price negotiations.
- Over 90% (471) of the lobbyist hires were made by clients supportive of the three harmful bills, outnumbering opposition 20-to-1. Supporters were either pharmaceutical companies, groups with pharmaceutical company members, or groups with ties to the industry.
- Big Pharma and its allies sent lobbyists to influence Congress, the White House, and various federal agencies, including the Centers for Medicare and Medicaid Services and the Department of Health and Human Services.
Big Pharma’s efforts have paid off handsomely. One of the three bills we analyzed – the ORPHAN Cures Act – passed into law through congressional Republicans’ July 2025 budget reconciliation bill. It will delay and exempt some of the most profitable drugs from negotiations. In an April executive order, Trump essentially endorsed another bill that would prevent negotiations for 11 years. Extending this already long delay risks permanently excluding many medicines from negotiations or providing patients access to lower drug prices for only one or two fleeting years.
Public Citizen is mobilizing to offset Big Pharma’s lobby and money power. We are lobbying members of Congress on the importance of preserving Medicare drug price negotiation. We have published issue briefs that explain how legislative proposals would exclude even blockbuster drugs from negotiation, and underscore that these bills do nothing for innovation but instead protect Big Pharma’s profits. We published a report that revealed how pharmaceutical company Amgen abused patents to prolong its monopoly on the autoimmune drug Enbrel, depriving Medicare of lower-cost alternatives.
In April, Public Citizen and dozens of other organizations wrote to members of Congress, urging them to oppose any legislative efforts to undermine the drug price negotiation program and to ensure the program can continue delivering lower costs for seniors and people with disabilities who rely on Medicare.
The negotiation program is an important tool in the fight to rein in Big Pharma’s runaway drug prices. But the work doesn’t stop at defending Medicare from corporate attacks. The program should be improved upon and expanded. “The loopholes and restrictions included in the Inflation Reduction Act already impose limits on savings for patients and taxpayers,” said Steve Knievel, an advocate with Public Citizen’s Access to Medicines program. “Instead of undermining the negotiation program, Congress should improve it to deliver lower prices for more drugs and more patients, including people with other kinds of insurance.”
The vast majority of Americans support Medicare drug price negotiations and support expanding the program to negotiate prices for all its prescription drugs to prices no higher than what other wealthy nations pay. Public Citizen is intent not just on defending the modest wins recently obtained, but delivering the fundamental reform that Americans support and need.