Welcome to the Week in Review.

Pushback: Pharma’s “IRA Watchdog” Analysis Misrepresents Medicare Negotiation

A recent report from DLA Piper argues that Medicare drug price negotiation is failing to deliver meaningful savings to seniors, but the analysis relies on false assumptions and flawed methodology, misrepresenting the truth. DLA Piper houses IRA Watchdog, a group backed by Bristol Myers Squibb, AstraZeneca, Merck, and Eli Lilly — several of which are simultaneously suing to block negotiation. The report narrowly defines “savings” in a manner that does not account for all drug pricing provisions, excluding key reforms such as the out-of-pocket cap and $35 insulin cap, inflation rebates, and Part D redesign. The headline claim that “only 11% of seniors save” relies on a restrictive framing; the same analysis notes that 15% of beneficiaries take a negotiated drug and 73% of those beneficiaries see lower cost sharing. The report also characterizes drugs like Tradjenta entering renegotiation due to generic or biosimilar competition as a negative for patients. Tradjenta’s lower negotiated price may no longer go into effect, but it’s because the drug now has competition — and competition often drives prices even lower than negotiated rates. Furthermore, the analysis incorrectly attributes trends that predate Medicare negotiation, such as premium increases, to the IRA. In short, the analysis minimizes documented savings, overstates access concerns, and is intended to advance the industry’s efforts to weaken negotiation. Lawmakers shouldn’t be fooled by these claims and should understand the financial interests behind them. — [DLA Piper, P4ADNow, Bloomberg Law, FightPharma]

E&C Health Subcommittee Hearing Results In Familiar Finger-Pointing

Representatives from across the drug supply chain, including PhRMA, BIO, Pharmaceutical Care Management Association (PCMA), and other industry groups, testified before the House Energy & Commerce Health Subcommittee this week. Notably absent were any patient voices. As expected, PhRMA blamed PBMs, PBMs blamed drug makers, and the structural drivers of high list prices received less scrutiny than they warranted. Still, several members of the committee pressed on core affordability issues. Lawmakers challenged PhRMA’s repeated claim that high drug prices are necessary for innovation, while others called attention to the secrecy surrounding drugmakers’ MFN pricing deals with President Trump, prompting PhRMA’s COO, Lori Reilly, to tell Congress that “you’ll have to take our word” that the agreements are good for patients. Pharma demands transparency from other actors in the supply chain, but when it comes to the prices they set, they insist we just have to trust them. Members also highlighted patent thickets and exclusivity tactics that extend monopolies well beyond statutory protections, delaying generic competition and driving up costs. While each sector debated its share of the dollar, one fact remains clear: brand-name drug companies play the biggest role in determining what patients will ultimately pay. — [E&C, YouTube, YouTube, YouTube, Washington Post, POLITICO, Roll Call]

TrumpRx: Hype vs. Reality

TrumpRx.gov is officially live, but important questions remain about its scope and impact. For 33 of the 43 drugs currently listed, TrumpRx’s prices match those already available on GoodRx, and reporting from STAT News indicates that at least 18 drugs have lower-cost generics available elsewhere. TrumpRx excludes many of the most widely prescribed and high-cost medications, including blockbuster drugs like Keytruda and Eliquis. Drugs on TrumpRx are also done through voluntary deals, and we have few details on how long their inclusion will last. For a small subset of patients — particularly those on certain GLP-1 or IVF drugs — the discounts could be meaningful, but for most Americans, including many cash-paying patients who can already find lower prices elsewhere, the real-world impact is likely limited, despite being marketed as a life-changing solution for millions. — [P4AD, STAT News, CBS News, Barron’s, Fierce Pharma, Common Dreams]

AbbVie Files Lawsuit against Medicare Negotiation

Just two weeks after Botox and Botox Cosmetic were named as drugs to be included in the third round of Medicare Drug Price Negotiations, manufacturer AbbVie, has filed a lawsuit in the U.S. District Court for the District of Columbia challenging the program. AbbVie argues that, as a plasma-derived product, Botox should be ineligible for negotiation under CMS guidance. The company also claims the program violates the First and Fifth Amendments by compelling speech through the negotiation framework and interfering with private property rights – constitutional arguments that closely mirror those raised in earlier pharmaceutical industry lawsuits challenging the program. While courts have repeatedly rejected similar constitutional claims brought by other manufacturers, AbbVie’s assertion that Botox qualifies as exempt on the basis of being plasma-derived marks a new line of argument in the ongoing litigation against Medicare negotiation. Botox is not simply a cosmetic product – it’s also used to treat a range of serious chronic conditions. Yet AbbVie is suing to protect its billions in profits rather than allow Medicare to secure lower prices for nearly 400,000 people on Medicare who rely on these medicines. — [P4AD, Bloomberg Law, Reuters, Endpoints News, Fierce Pharma, BioSpace, Law360]

ICYMI

In addition to driving down prices, Medicare negotiation is also expanding coverage of included medications. A new analysis from KFF finds that in 2026, all Part D enrollees have coverage of the first 10 negotiated drugs — including all dosages and forms — as required through the IRA. Coverage rates improved for multiple formulations of 9 of the 10 drugs compared to 2025, with especially large gains for insulin products Fiasp and NovoLog and certain doses of the cancer drug Imbruvica. The impact of Medicare negotiation for patients extends far beyond lower negotiated prices. — [KFF]

Patient Advocate Spotlight: Stacy Dyke

Condition: Hemiplegic Migraines, Occipital Neuralgia, Idiopathic Intracranial Hypertension, and Fibromyalgia

Drugs: Nurtec, Spravato, Reyvow, Trudhesa, and Zavzpret (totaling ~$8,500 per month list price)

Background: Patient advocate from Shreveport, Louisiana

In Her Words: “I’m navigating a medical system that often feels designed against me. Each day is a battle against relentless pain, a battle made even harder by the exorbitant cost of treatment. I’ve cycled through countless medication trials, from ineffective generics to brand-name drugs that carry a hefty price tag — commonly ranging from $400 to $6,000 a month each, and forcing me into a continuous struggle to afford my medications. Life often feels like a never-ending game of chess, constantly strategizing to manipulate a broken system and anticipate the next move. This shouldn’t be our reality.”

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