not used title
not used title
Government price setting policies like Most Favored Nation-pricing are bad for American patients, especially over the long term. These “foreign first pricing” schemes don’t guarantee lower costs. Instead, they take away dollars that could be invested in American manufacturing and undermine biopharma R&D. Most importantly, foreign reference pricing fails to address the real reasons Americans pay more for medicines than other countries: pharmacy benefit managers (PBMs), 340B hospital markups and foreign governments not paying their fair share for innovative medicines.
To lower drug costs in America, policymakers must:
- Hold PBMs accountable
In 2023, PBMs took $140 billion in rebates and fees, driving up American medicine costs. These PBM profits may exceed the total cost of drugs overseas. Just three PBMs control nearly 80% of the U.S. market and they dictate what medicines patients can get, what they pay and what hoops they must jump through.
- Fix the 340B Hospital Markup Program
The little-known federal 340B program is a $66 billion program that lets big, tax-exempt hospitals and clinics buy medicines for as little as a penny and then markup the price by thousands of dollars. Hospitals abuse the program to boost their profits at the expense of patients, taxpayers and employers. This program is leading to higher medicine prices in the U.S.
- Make foreign countries pay their fair share
European countries routinely adopt pricing and reimbursement policies that undervalue medicines, making U.S. patients foot a disproportionate share of the bill for incentivizing the R&D investment for medicines used around the world. These tactics include biased pricing formulas, mandatory discounts, clawbacks and referencing prices paid by lower income countries. Policymakers can use trade negotiations to force countries to pay a minimum percentage of their GDP per capita on new innovative medicines to ensure everyone is paying their fair share.
Taken together, these policies can support American patients in accessing and affording the medicines they need, while ensuring the United States remains the global leader in biopharmaceutical innovation.
Brianna Allen
Brianna is a Senior Director on PhRMA’s Public Affairs team focusing on communications strategies and activities around Medicare, Medicaid and access to medicines. Prior to joining PhRMA, she served as a strategic communications advisor at the FDA’s Center for Devices and Radiological Health and worked as a director of strategic communications on FGS Global’s health care team. She started her career in journalism and spent nearly a decade covering domestic policy issues, including federal health policy for POLITICO. She enjoys spending time outdoors exploring Northern Virginia with her husband, two toddlers and corgi puppy.
Brianna Allen headshot
New poll: 2 in 3 voters prefer a candidate committed to lowering health insurance premiums
September 18, 2026
As football season kicks off, hospitals keep scoring on 340B
September 9, 2026
ICYMI: Hospital consolidation is driving up health care costs
August 27, 2026
What AARP isn’t telling seniors about MFN
August 24, 2026
It's time to modernize 340B: The case for a rebate model
August 19, 2026
Policymakers should improve patient access and reject price controls
August 18, 2026
CMS proposal could discourage patient-centered innovation
August 18, 2026
Insurers blame GLP-1s for rising costs. The data tells a different story.
August 14, 2026
The FTC’s PBM enforcement actions gave us a glimpse behind the curtain; it’s time to let the light in.
August 7, 2026
Nearly 1 in 4 patients initially denied access to IRA medicines
August 6, 2026
Voters continue to voice their concerns on government price controls
July 24, 2026
ICYMI: Fox business hosts call 340B a ‘Rotten System’ and ‘Cash Cow’ for hospitals
July 23, 2026
Medicare Part D at 20: Building on a strong foundation
July 23, 2026
Message to USAging: Providers are raising concerns about coverage barriers
July 22, 2026
New PBM principles don't change the fundamental challenge: Access to lower-cost medicines
July 10, 2026
340B’s reality: A booming business for hospitals, pharmacies and corporate giants
June 25, 2026
Guest Blog: Price controls won’t lower costs when insurers control access
June 25, 2026
Insurers are blaming medicines for premium hikes in Massachusetts. The state's own data suggests otherwise.
June 24, 2026
340B’s lack of guardrails lets big hospital systems turn it into an oversight-free revenue stream
June 22, 2026
MFN could disrupt the affordable medicines patients depend on
June 18, 2026
New “America Cures” ad: U.S. patients get new medicines first
June 15, 2026
Private equity's new play? Become a nonprofit to profit off 340B.
June 5, 2026
Patients speak out: MFN won't address my affordability concerns
June 4, 2026
MFN price controls threaten American jobs and the U.S. economy
May 28, 2026
340B is growing, but it is unclear if Illinois patients benefit
May 27, 2026
Ahead of ASCO: Cancer innovation is promising, but policy choices matter
May 26, 2026
State price-setting boards create more questions than answers
May 20, 2026
Fox Business spotlights hospitals abuse of the 340B program
May 15, 2026
New analysis highlights access to new medicines in the United States and abroad
May 13, 2026
The Wall Street Journal raises new alarms about 340B
May 11, 2026
MFN won’t lower costs when insurers call the shots
May 8, 2026
Hospitals in the hot seat: Congress sharpens focus on 340B, consolidation and rising costs
May 7, 2026
New "Goldmine” ad reveals hospitals hide how they profit from 340B markups
May 6, 2026
Guest Blog: How MFN price controls could decide my health care
April 30, 2026
A program off track: How 340B drives both hospital consolidation and system gaming
April 27, 2026
Washington Post Editorial Board says 340B has become “corporate welfare”
April 27, 2026
Briefing: Capitol Hill panel on "Healthcare Denial Crisis in America"
April 24, 2026
MFN price controls would drain pensions and put retirements at risk
April 23, 2026
Survey confirms too many insured Americans face barriers to reliable health care
April 22, 2026
States should avoid repeating the IRA’s price‑setting mistakes
April 21, 2026
Modernizing 340B using rapid verification: The case for a rebate model
April 20, 2026
CMS undermines medical progress with MFN price controls
April 16, 2026
Trump Administration’s efforts to have other countries pay their fair share are underway
April 15, 2026
70% DENIED: How insurance denials are delaying and preventing care for millions of Americans
April 14, 2026
CMS’ MFN proposals won’t help seniors despite lofty promises
April 9, 2026
Voters voice concerns on government price controls
April 7, 2026
Virginia should be cautious about importing federal price-setting mechanisms
April 1, 2026
Policymakers shouldn’t double down on the IRA’s flaws with MFN
March 30, 2026
Hospitals drive nearly 80% of the U.S. health spending gap
March 25, 2026
Congress should look under the hood of 340B, hospitals don't want them to
March 19, 2026
MFN drug pricing risks reviving a harmful metric the U.S. rejected
March 16, 2026
340B hospitals buy low and sell high, a new analysis shows
March 12, 2026
Leadership in biopharmaceutical R&D provides U.S. patients the greatest access to innovative medicines
March 11, 2026
New report from Minnesota: 340B is generating billions for big hospitals
March 9, 2026
Harmful U.S. policies will help drive China’s global leadership in biopharmaceutical innovation
March 4, 2026
MFN undermines U.S. biopharmaceutical innovation
February 25, 2026
340B hospital markup scheme is costing states, taxpayers billions
February 25, 2026
CMS puts patients and innovation at risk with MFN
February 24, 2026
Questions mount over 340B program and increased cost to everyone
February 23, 2026
No hassle, hidden markups or fees: AmericasMedicines.com
February 19, 2026
PhRMA Forum 2026 highlights the importance of fostering the next era of American leadership
February 18, 2026
The Federal Trade Commission (FTC) takes important action to highlight and curb PBM abuses
February 17, 2026
Separating fact from fiction in the medicine supply chain
February 11, 2026
New list of selected drugs highlights growing consequences of government price setting
January 28, 2026
50-state poll says Americans are concerned that hospital markups hurt patients
January 27, 2026
Three things you should know from the insurer CEO congressional hearings
January 26, 2026
New analysis finds 340B hospitals push patients toward costly care to boost profits
January 21, 2026
Price setting policies put cancer gains in jeopardy
January 16, 2026
Can’t get your medicine? Don’t count on your insurer.
January 15, 2026
Data shows tax-exempt hospital profit-seeking behavior, not drug prices, is driving explosive 340B expansion
January 8, 2026
Big, tax-exempt hospitals are charging cancer patients, employers massive medicine markups
January 5, 2026
340B’s billion-dollar boom: Oversight lags as spending soars
December 19, 2025
New study: 340B rebate model pilot won’t hurt cash flow for providers
December 18, 2025
One thing the Senate can agree on: It’s time to fix 340B
November 25, 2025
Myth vs. Fact: How government price setting impacts innovation
November 24, 2025
The IRA’s price setting doesn’t guarantee lower costs or better access
November 17, 2025
Stop, collaborate and re-evaluate: ICER’s pricing report
November 14, 2025
California’s landmark PBM crackdown: A wake-up call for reform
November 13, 2025
Middlemen mark up drug prices and keep discounts meant for you
November 10, 2025
The Administration approves manufacturers’ 340B rebate pilot plans
November 6, 2025
PhRMA calls on USTR to ensure foreign nations pay their fair share
November 4, 2025
Putting patients first: Breaking down barriers to care
October 28, 2025
Direct purchase programs can lower costs for patients
October 20, 2025
340B abuses are fueling higher Medicare costs, new BRG report shows
October 15, 2025
What seniors can expect this open enrollment
October 14, 2025
Part D premiums are going up, while choices are going down
October 8, 2025
PBMs say they want lower priced medicines, so why don’t they cover them?
October 7, 2025
Historic biopharmaceutical investments: A prescription for America’s future
September 29, 2025
ICYMI: The Wall Street Journal calls 340B reform a “good idea to cut drug costs”
September 23, 2025
340B hospitals use scare tactics to evade accountability
September 16, 2025
Why states struggle to deliver savings: Middlemen and 340B siphon dollars from patients and states
September 15, 2025
CBO: 340B program costs taxpayers, no evidence patients benefit
September 10, 2025
PhRMA stresses importance of 340B Rebate Model Pilot
September 9, 2025
New “Meet Mark” ad exposes how the 340B hospital markup program drives up costs for everyone
September 3, 2025
New study unmasks how big-city hospitals exploit 340B by posing as rural providers
August 21, 2025
PBMs are hiding hurdles to essential care
August 20, 2025
Study: 340B hospitals drive up patient drug costs
August 15, 2025
Curbing 340B abuse and rising costs with the rebate model
August 12, 2025
Celebrating 60 Years of Medicare
July 30, 2025
New study: PBMs and commercial insurers are quietly blocking prescription access
July 30, 2025
North Carolina puts patients first with rebate pass-through law
July 29, 2025
PBMs, not patents, are blocking access to lower-cost medicines
July 23, 2025
Medicare patients face higher drug costs, despite IRA promises
July 22, 2025
The hidden cost of 340B: A multi-billion-dollar burden on taxpayers and Medicaid
July 14, 2025
Latest analysis from Ohio exposes growing abuses of the 340B markup program
July 7, 2025
CMS continues to make a bad law worse
June 27, 2025
ICYMI: Forget Foreign Price Controls: There’s a better solution to lowering drug prices
June 26, 2025
New report finds rampant abuse of the 340B program
June 20, 2025
Americans are paying a 26% freerider tax on medicines because other countries don’t pay their fair share
June 17, 2025
Medicare Part D plans initially denied medicines for more than 70% of patients in four chronic disease areas
June 16, 2025
How the 340B hospital markup program could hurt Michigan patients
June 12, 2025
New “Balance the Scales” campaign highlights why Americans pay more for prescription medicines
May 21, 2025
How the 340B hospital markup program and PBMs drive up costs for U.S. patients
May 16, 2025
The AHIP premium dollar corrected (again)
May 8, 2025
PBMs launch new ad campaign to block reforms
May 5, 2025
New analysis: Fewer treatments and cures under the IRA’s pill penalty
May 1, 2025
When hospitals have free rein to mark up drug prices, who pays the price?
May 1, 2025
When middlemen own it all, patients pay the price
April 10, 2025
How the IRA is impacting the generic drug market
April 8, 2025
3 myths critics get wrong about intellectual property
March 28, 2025
New report finds more abuse of 340B program by hospitals and drug middlemen
March 24, 2025
Three reasons Congress should fix the IRA’s pill penalty
March 24, 2025
A closer look at how health care consolidation drives up patient costs, creates barriers to care
March 17, 2025
Health care practitioners sound the alarm on middlemen-imposed barriers to patient care, need for policy change
March 13, 2025
Congress Keeps PBMs in the Hot Seat
March 6, 2025
340B markup program is a hidden tax, increasing costs for employers, straining state and federal budgets
March 5, 2025
Improved treatments continue to lead to declining cancer mortality rates in the U.S.
February 25, 2025
New report sheds light on payment flows in the pharmaceutical supply chain, including the role of 340B and vertical integration
February 13, 2025
Virginia, Don't Let Politicians Take Away Your Medicine
January 23, 2025
Patients are losing as government price setting continues
January 17, 2025
Wrapping up the J.P. Morgan Healthcare Conference
January 16, 2025
NYT exposes hospitals, middlemen make millions off a hospital markup program
January 15, 2025
FTC finds PBMs make billions in profit from marking up cancer, other critical generic drugs
January 14, 2025
PhRMA CEOs Tee Up Next Week's Health Care Conference
January 11, 2025
New study: Entities that don’t make medicines get half of what is spent on those medicines
January 7, 2025
A new administration poses new opportunities for patient access
December 17, 2024
New 340B report from Minnesota exposes steep hospital markups on medicines, patient benefits remain unclear
November 27, 2024
Michigan hospitals using federal program to markup cost of medicines, gouging patients
November 27, 2024
340B spending is exploding, forcing prices up for patients, employers and government programs
November 13, 2024
Post-approval R&D is critical for fighting cancer. The IRA makes it more difficult.
November 13, 2024
Three things to know about 340B contract pharmacies
November 12, 2024
The PBM industry's desperate attempt to stop reform
November 12, 2024
PhRMA launches new ad calling for Congress to make sure savings go to patients, not PBMs
November 11, 2024
CMS needs to do better
November 4, 2024
ICYMI: Grounding policy reforms in real lived patient experiences is key to improving outcomes
October 31, 2024
New PES survey: Out-of-pocket costs lead key health care priorities ahead of the November election
October 30, 2024
Guest Post: My health care vote
October 29, 2024
Insurers continue shifting more costs on to patients
October 28, 2024
Americans speak out on health insurance barriers and need for policy change, according to the latest Patient Experience Survey
October 28, 2024
ICYMI: The powerful companies driving local drugstores out of business
October 25, 2024
Is CMS paying attention to the growing access barriers for Medicare patients under the IRA?
October 18, 2024
PhRMA urges HRSA not to impede new 340B pricing approaches to improve transparency and integrity
October 18, 2024
7 reasons why states shouldn’t copy the IRA’s price setting mistake
October 15, 2024
Did the administration consider the importance of blood cancer medicines to patients in price setting process?
October 8, 2024
Hispanic Heritage Month: Fighting for Hispanic patients
October 7, 2024
Illegal abuse of 340B hurts us all
October 3, 2024
Did the administration consider the importance of blood clot medicines to patients in the price setting process?
September 25, 2024
PBMs and insurers off the hook: Sen. Sanders’ selective hearing on drug costs
September 24, 2024
Three ways state drug price setting boards fail patients
September 18, 2024
The Inflation Reduction Act could increase costs and reduce access for millions of seniors
September 17, 2024
Are the IRA’s Part B inflation rebates lowering costs for Medicare patients? No.
September 16, 2024
Did the administration consider the importance of autoimmune disease medicines to patients in price setting process?
September 11, 2024
Key voter insights two months from Election Day
September 10, 2024
Patient priorities in the 2024 election
September 10, 2024
Did the administration consider the value of innovative diabetes medicines in price setting process?
August 28, 2024
New survey: Insurers confirm IRA will reduce patient treatment options
August 20, 2024
The unintended consequences of government price setting in Medicare Part D
August 16, 2024
Don’t put the government between patients and their medicines
August 7, 2024
Biosimilars continue to drive market competition and increase savings for seniors
August 6, 2024
What is the low-income subsidy program and how is it changing?
July 31, 2024
Voters across all 50 states want state policymakers to focus on health insurance and PBM practices
July 30, 2024
Case study: How seniors could face access disruptions because of the IRA’s price setting provisions
July 22, 2024
WTAS: Voters voice concerns about PBM abuses, call on policymakers to act
July 19, 2024
PhRMA launches new ad in campaign exposing ways middlemen drive up costs
July 17, 2024
FTC report confirms PBMs profit at the expense of patients
July 10, 2024
New 50-state poll Americans want to hold health insurers and PBMs accountable for high out-of-pocket costs and other practices
July 9, 2024
PhRMA reiterates concerns with IRA price setting program, urges CMS to mitigate harm
July 3, 2024
ICYMI: Hidden markups at mail-order pharmacies increase costs for employers
July 2, 2024
340B sales go up, free or reduced-cost care offered at hospitals goes down
July 1, 2024
More than 60 researchers advocate on Capitol Hill
July 1, 2024
The IRA could lead to higher out-of-pocket costs for 3.5 million Medicare patients in 2026
June 25, 2024
ICYMI: What patients care about this election year
June 24, 2024
ICYMI: The Opaque Industry Secretly Inflating Prices for Prescription Drugs
June 21, 2024
ICYMI: Health care policy should be driven by patients, not politics
June 10, 2024
ICYMI: Misaligned policies undermine patient access
June 6, 2024
PhRMA Warns Federal Agencies: Consolidation and vertical integration among insurers, PBMs, and hospitals threaten patients
June 5, 2024
The hidden bill patients don’t know they are paying
June 3, 2024
ICYMI: Innovation transforms lives but misguided federal policies threaten patient outcomes
May 30, 2024
How the IRA is more coercive than any European government price setting scheme
May 29, 2024
Mental Health Awareness Month: Supporting loved ones and improving mental health in America
May 28, 2024
How government price setting fails to address systemic health care inequities
May 24, 2024
Ongoing federal probes shed light on PBM and insurer practices
May 20, 2024
340B grows and grows, but patients do not see the savings
May 13, 2024
340B grows and grows, but patients do not see the savings
May 13, 2024
Government price-setting boards: Why Minnesota needs to take a better approach
May 9, 2024
WTAS: The consequences of consolidation and vertical integration
May 6, 2024
IRA is already negatively impacting access to medicines in Part D
April 25, 2024