Welcome to the Week in Review.
Government Funding Health Package Advances PBM Reforms & Generic Competition
The House passed a government spending bill on Thursday that includes key drug price reforms that P4AD has consistently pushed for since 2023. The package incorporates the Q1/Q2 provision originally included in the bipartisan Lower Costs, More Transparency Act, which would address a crucial barrier to generic drug approvals by requiring the FDA to provide clearer guidance on ingredient differences in generic drug applications, saving generic manufacturers time and money in bringing lower-cost alternatives to market. A 2023 CBO estimate found that Q1/Q2 would save taxpayers $871 million over a decade. The bill also includes a provision that would delink PBM compensation from drug prices in Medicare Part D, curbing incentives to steer patients toward more expensive prescription drugs. It would also expand reporting requirements to increase transparency for plan sponsors. While these steps represent important steps forward, significant work remains to achieve the systemic reforms still needed to lower drug prices for everyone. The bill now moves to the Senate, which will be back in session on Monday. — [CBO, STAT News, Endpoints News]
Drugmaker Greed and Shameful Threats on Display at JPMorgan Healthcare Conference
Last week’s JPMorgan Healthcare Conference underscored that pharmaceutical executives view President Trump’s most-favored-nation (MFN) pricing push as a threat to be countered. Pfizer CEO Albert Bourla warned that if U.S. prices were lowered to match countries like France, Pfizer would stop selling new medicines there — signaling a willingness to hold entire countries hostage by restricting access to medicines in order to protect higher U.S. prices. Bristol Myers Squibb (BMS)’s executives echoed that approach, pointing to a December U.K. agreement in which the company raised prices after threatening to withhold a new schizophrenia drug, arguing the “deal did not go far enough.” The strategy is familiar: after President Trump’s July letters urging 17 drugmakers to align U.S. prices with those of other high-income countries, Eli Lilly announced plans to raise prices in Europe. What stood out at the JPM conference was how openly and callously executives discussed “the dealmaking calculus” behind these moves — using large portfolios to selectively raise prices or limit supply in lower-priced markets to preserve massive profit margins. Raising prices abroad is pharma attempting to game the system and shift costs elsewhere, and it does nothing to lower costs for U.S. patients. The takeaway was unmistakable: the industry is only focused on maximizing profits with little regard for the lives they harm. — [Financial Times, CNN, Endpoints News]
Supreme Court Eyes Patent Laws & Pharma Lawsuits
On Thursday, the Supreme Court rescheduled AstraZeneca’s petition, choosing to hold its decision until further notice. The company’s petition seeks to block the price reduction of its diabetes drug, Farxiga, and blood cancer drug, Calquence — the latest effort in the industry’s broader legal campaign to undermine or completely stall Medicare drug price negotiation. Separately, the Court agreed last week to review a case involving skinny labels. This long-standing legal protection allows generic manufacturers to compete with name brands without infringing on secondary patents. It’s a practice that’s allowed generic drugs to find a foothold in the market, despite the pharmaceutical industry working hard to manipulate the U.S. patent system and block competition. Research shows that the competition from one generic entering the market can drive a medication’s price down by 39%, with six or more competitors reducing it by as much as 95%. P4AD supports the protection of skinny labelling and the affordable generic alternatives it delivers for patients, and will be closely watching both cases as the Court weighs issues with major implications for drug prices and patient access. — [STAT News, FDA, SCOTUS, The Hill, Endpoints News]
Drug Affordability Takes Center Stage in House
The House held a series of hearings this week on healthcare and drug affordability. In a Budget Committee hearing, Rep. Doggett (D-TX) pushed back on pharma’s claim that high prices are necessary for innovation, noting that no other industry makes that argument and that much early-stage innovation comes from unprofitable startups. He pointed to stalled biosimilar approvals as a clear area for reform. In Thursday’s Health subcommittee hearing, Rep. Harshbarger (R-TN) and Rep. Trahan (D-MA) warned that vertical integration between PBMs, pharmacies, and insurers has concentrated market power and weakened competition. Rep. Mariannette Miller-Meeks (R-IA) went further, criticizing PBMs for using group purchasing organizations to sidestep oversight and extract additional revenue. The throughline was clear: high drug prices are not a partisan issue, and meaningful relief for patients will require bipartisan action. Real progress will depend on whether Congress translates this concern into action that delivers lower prices for patients. — [House, X, House, X]
Patient Advocate Spotlight: Patricia Sportsman
Condition: Chronic obstructive pulmonary disease (COPD)
Drugs: Trelegy ($563 per month) in addition to Symbicort and Albuterol
Background: Senior from Coos Bay, Oregon
In Her Words: “My Trelegy prescription used to only cost me around $300 for a 90-day supply, totalling about $100 a month, which was financially doable for my situation. That price, however, changed at the beginning of 2025 when I realized my monthly cost would be $563 per month.”
“This is unfathomable. What senior citizen has this type of money? I certainly don’t, and have thus gone without the medication for 2 months. This is why a negotiated price for Trelegy is so crucial and important to me. Drug companies have overpriced their medications for too long, but the Medicare Negotiation Program can prevent this from going any further, lowering costs for patients, like myself, and taxpayers.”
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