Earlier this week, we debunked pharma’s lies about how drug pricing reforms will hinder innovation and patient access to medications. We also explained how taxpayers played a critical role in funding the research and development of COVID-19 vaccines. See our full campaign to set the record straight on the comprehensive reforms in Congress here.

Today, we’ll address pharma’s false claims about out-of-pocket costs.

Big Pharma’s Lie: Patients only care about lowering out-of-pocket costs. We don’t need comprehensive reforms. 

✅ The Truth: The Truth: We can’t lower out-of-pocket costs without lowering drug prices or we will just wind up paying higher premiums and taxes. We need comprehensive reform.

Watch here.


Big Pharma has attempted to create a false dichotomy by claiming patients only want their out-of-pocket costs to go down. That’s simply impossible. In order to lower out-of-pocket costs for patients, we must lower underlying prices, or we will simply pay more in premiums and higher taxes because insurers and federal health plans will make up the difference through cost shifting. Capping out-of-pocket costs without lowering drug prices simply shifts costs – it doesn’t lower them. The Alzheimer’s drug Aduhelm is a prominent example of this process: After the manufacturer, Biogen, priced the drug at $56,000 per year, the Centers for Medicare and Medicaid Services announced that Medicare Part B premiums would increase by nearly 15 percent the following year — one of the largest increases ever — to accommodate the astronomical cost. Passing the comprehensive drug pricing reforms that include Medicare negotiation will address the headwater of the issue — high list prices — and lead to lower prices and out-of-pocket costs for patients.

Taxpayer Perspective:

High drug prices are a major challenge for small business owners and leaders. In a recent statement, Rhett Buttle, senior advisor for Small Business for America’s Future, explains: “We also need to help small businesses with unreasonable expenses that cut into their bottom line and hinder their growth. … Small business owners identify the cost of healthcare and prescription drug prices as their top concern and strongly support solutions like allowing Medicare to negotiate the price of prescription drugs.”

Nevada teacher and type 1 diabetes patient Jamie Tadrzynski writes in the Las Vegas Sun, “Any proposal that caps the cost of one or more drugs will not fundamentally address the root of the problem, which is rising prices. The government can take action to help seniors and others afford their medicine, but without negotiations that actually stop the drug corporations from charging whatever they want and raising prices at will, cost containment can only have limited impact for a limited number of patients while burdens continue to rise for taxpayers, businesses, and those paying premiums.”