Get to Know Sarah Karlin-Smith
Public Citizen News / July-August 2026
This article appeared in the July/August 2026 edition of Public Citizen News. Download the full edition here.
For 15 years, Sarah Karlin-Smith made a career of explaining how policy decisions made in Washington ripple through doctors’ offices, pharmacies, and household budgets. Before joining Public Citizen’s Access to Medicines Program as research director in January 2026, she covered health policy and politics for Politico, FDA News, and Pink Sheet, and was a regular voice on KFF Health News’ “What the Health” podcast. Along the way, she also taught an introductory news writing course at George Washington University, where she helped students think critically about the media they consume and recognize how decisions about what stories get covered
A graduate of George Washington University in D.C., where she studied journalism, mass communication, and American Studies, Karlin-Smith has lived in Washington for roughly two decades. When not working, she can often be found ferrying her young children around the city on the family e-bike, practicing yoga, or volunteering as an amateur clown who twists balloon animals. Raised in New Jersey, she remains a spirited defender of her home state and keeps a running mental list of its many contributions to the world.
Q: What drew you from reporting on health issues to working on the policy side?
A: After spending so many years learning and writing about the many problems in the U.S. health care system, it’s exciting to have an opportunity to more directly advocate for positive change. The drug industry has so many paid voices working on its behalf in Washington; the public needs strong opposition working in its interests.
Q: What’s one misconception the public often has about how drug pricing in the U.S. actually works?
A: Many people assume that the price of a drug is linked to how much it costs to develop. But drug pricing is not tied to the cost of research and development, and the vast majority of pharma industry revenue is not spent on R&D. Drug companies generally price their medicines to maximize profits, even if it means that many people lack access to needed drugs.
Q: Looking ahead, what developments in drug pricing or access to medicines do you think deserve far more public attention right now—and what gives you hope that meaningful reform is still possible?
A: Congress giving Medicare the power to negotiate the cost of some drugs was a huge achievement in the U.S. drug pricing space. Now that this program has had a few years to play out and the sky hasn’t fallen — that is, innovation and development of new drugs continue — there is an opportunity to build on this momentum. There are a variety of ways to build out the Medicare program to get lower costs on more drugs and include people covered by different health insurance programs.
Q: If you could make RFK Jr. read one book or consume another cultural object, what would it be?
A: RFK Jr. often seems to operate under the assumption that health is nearly entirely within a person’s personal control and pushes policies that align with this belief. I’d want him to read content that shows how much of a person’s health is beyond their control and driven by biology and social and economic factors, such as where they live and how much they earn.