Welcome to the Week in Review.

Medicare Negotiation Moves Forward Despite Industry Attacks

The Centers for Medicare and Medicaid Service (CMS) has announced that all 12 manufacturers of the 15 drugs selected for the second round of the Medicare negotiation program have voluntarily agreed to participate. Overshadowing this key moment however is the fact that six of the drug manufacturers previously filed lawsuits between June 2023 and January 2025 to halt the program — which, if successful, would block significant price reductions for patients and billions in potential taxpayer savings. But these legal attacks aren’t the only threat to the popular program. Three bills have been re-introduced in Congress — The Orphan CURES Act, The EPIC Act, and the MINI Act — unnecessary giveaways to Big Pharma that would create new loopholes for drug companies to avoid negotiation for longer and for more drugs. These attacks, both in the courts and in Congress, make it clear that Big Pharma’s lobbyists and lawyers are doing everything they can to undermine the reforms patients fought hard to achieve. But there is also reason for some hope. At his confirmation hearing last week, likely CMS Administrator Dr. Mehmet Oz, pledged to “defend” and “use” the program when asked whether he would protect Medicare negotiation in court. With the law under attack from multiple fronts, P4AD remains committed to holding leaders accountable and ensuring the Medicare negotiation program is successfully implemented and able to deliver real relief to patients. — (CMS, P4AD, Fightpharma.org, P4ADNow, P4AD, P4ADNow, Drug Topics, Axios, P4AD)

PBMS Under Fire For Driving Up Drug Prices

Pharmacy benefit managers (PBMs) continue to face scrutiny for their role in driving up prescription drug prices. At the Managed Health Care Associate’s 2025 Business Summit this week, P4ADNow Executive Director Merith Basey exposed how PBM’s opaque and anti-competitive practices inflate drug prices. Highlighting findings from the Federal Trade Commission’s (FTC) report, Merith shared how PBMs manipulate formularies to favor high-cost brand-name drugs over lower-cost generics and biosimilars while pocketing massive rebates from manufacturers – with patients bearing the brunt of these practices. Bert in Pennsylvania, saw his PBM suddenly stop coverage of his Symbicort inhaler, forcing him to alternatives that caused severe side effects. In Michigan, Stacey’s PBM refused to cover her husband’s life-saving insulin, leaving them scrambling for options. With growing bipartisan momentum in Congress to address the shady practices of PBMs, there is an opportunity to drive overdue reforms that prioritize patients. P4ADNow supports efforts to end the PBM black box by increasing transparency, holding PBMs accountable for manipulating formularies to prioritize higher-cost drugs, and reining in vertical integration. — (P4ADNow, Federal Trade Commission, Commonwealth Fund)

DTC Ads Drive Up Costs For Taxpayers

The 10 largest drug companies in the U.S. spent a staggering $13.8 billion on direct-to-consumer (DTC) advertising in 2023 — and because this spending is tax-deductible, it effectively shifts the financial burden to taxpayers. A new analysis from the Campaign for Sustainable Rx Pricing (CSRxP) found that eliminating this tax break or banning DTC ads could raise federal revenues by up to $1.7 billion. DTC ad spending also directly contributes to higher drug prices. The analysis also highlighted that, according to the Congressional Budget Office, a 10% increase in DTC ads leads to a 2.3% rise in drug spending. The U.S. is one of only two countries in the world – alongside New Zealand – that allows DTC prescription drug ads, and Americans pay between four to eight times more for prescription drugs compared to people in other high-income nations. While some lawmakers are pushing for greater transparency in pharmaceutical advertising, more action is needed to address DTC ads and Big Pharma’s tactics that lead to higher drug prices. — (Tech Target, Campaign for Sustainable Rx Pricing, Politico, Congressional Budget Office, USC Schaffer, RAND)

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