not used title
not used title
For months Congress has been debating massive changes to the nation’s social safety net, one of which is the highly popular Medicare prescription drug benefit. Unfortunately, much of what is being debated around that benefit today loses sight of the real barriers to a better health care system. It is a fact that too often, accessing medical treatment in the United States is harder than it should be. Today, three in 10 Americans face financial barriers to care – and that’s Americans with health insurance. Access hurdles exist throughout the health care system, including doctors’ visits, hospitals, insurance premiums and deductibles and, yes, medicines. 
Congress is absolutely right to address these issues, as no one should have trouble accessing the care they need, especially not in a country like the United States. What’s unfortunate is the debates happening on Capitol Hill seem to have lost sight of the bigger picture and are not addressing the real drivers of patient angst. By proposing draconian policies that would dramatically increase government involvement within the health care system, some members of Congress risk not only making health care access issues worse, but also isolating voters who have voiced clear concerns around policies like H.R. 3. The most recent drug pricing proposal in the Build Back Better legislation ignores those concerns and will create a system where one person – a government official – will have the unprecedented authority to determine the value of a medicine. This will inevitably lead to access restrictions for seniors.
Patient Access to Medicines
Let’s take access to medicines. More medicines are available in the United States than any other country, and yet 41% of U.S. patients last year did not take their medicines as prescribed, whether through pill splitting or not filling their prescription at all. This duality stems from myriad factors, including out-of-pocket costs that have risen substantially for many patients in recent years. Unfortunately, many proposals in Congress do not address the underlying incentives that drive access and affordability challenges in the U.S. Rather, these policies presume government price-setting could be a silver bullet – a dogmatic position that may sound reasonable without any context, but proves unworkable as soon as we examine the broader landscape.
The insulin market is a great example. If we account for the rebates and discounts that health insurance companies and pharmacy benefit managers (PBMs) receive from insulin manufacturers, net prices for the most commonly used insulins have gone down by 40-50% since 2014. But because these savings are not always directly shared with patients, it often doesn’t feel that way. Instead, as health insurers shift more financial responsibility onto patients in the form of higher deductibles and coinsurance, people with chronic conditions like diabetes face higher out-of-pocket costs, effectively subsidizing the healthy. That’s not how insurance is supposed to work! To help address these challenges, two of our members recently launched generic versions of their insulins. But both have struggled with uptake, in part because some insurers chose not to cover them. Excluding lower cost options for patients may be a byproduct of incentives in our current system, which policymakers and experts have noted can lead health plans and PBMs to favor medicines with high list prices and large rebates.
Voter Concerns
Beyond failing to address the broader drivers of affordability challenges, government price-setting policies like that in the Build Back Better plan are not even what voters want. Recent polling shows that once you inform people that draconian price-setting policies will necessarily reduce access to treatments – and jeopardize the development of future ones – they realize it’s not worth the tradeoff. When told that Medicare “negotiation” could limit people’s access to newer prescription medicines, initial support plummets from 63% to 14%, according to a new Ipsos/PhRMA poll. The same poll showed that when given the choice, 77% of voters say Congress should focus more on reducing the overall costs of health care coverage, such as premiums, deductibles and copays, versus the list prices of prescription medicines (22%).
Study after study (after study) indicates that government price-setting policies would result in fewer medicines coming to market due to reduced investment in R&D – with life-threatening consequences. Those lost medicines could include critical future treatments and cures that would never make it to patients.
A Better Way 
As a lifelong Democrat, the current debate in Congress is truly disappointing. So many Americans have raised concerns over price-setting policies, and these concerns seem to fall on deaf ears. Rather than take time to develop thoughtful policies that solve the real issues voters are facing, policymakers have chosen to focus on dogma and soundbites. Without addressing the ecosystem and the cost drivers that really stand in the way of patient affordability, we won’t truly help patients.  
We’ve proposed a list of patient-centered solutions that would more effectively help people afford their treatments by addressing the broad, fundamental problems in our health care system. It’s up to those in Congress whether they want to listen.
Debra DeShong
Debra DeShong is Executive Vice President of Public Affairs at PhRMA. In this role, Ms. DeShong serves as a lead spokesman for the association and manages multiple high-profile public affairs campaigns on the value of biopharmaceutical innovation, patient access to medicines and other industry priorities. Ms. DeShong has more than two decades of experience in public policy, communications and international relations, which includes serving as Chief of Staff to U.S. Ambassador to Japan Caroline Kennedy, working as a founder and executive at Washington public affairs firms Point Blank and Five by Five and holding top communications positions with the United Nations Foundation, U.S. Senator Robert Torricelli, the Democratic National Committee and the John Kerry for President campaign.
Debra DeShong
New poll: 2 in 3 voters prefer a candidate committed to lowering health insurance premiums
September 18, 2026
What AARP isn’t telling seniors about MFN
August 24, 2026
Policymakers should improve patient access and reject price controls
August 18, 2026
CMS proposal could discourage patient-centered innovation
August 18, 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
Medicare Part D at 20: Building on a strong foundation
July 23, 2026
Guest Blog: Price controls won’t lower costs when insurers control access
June 25, 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
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
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
New analysis highlights access to new medicines in the United States and abroad
May 13, 2026
MFN won’t lower costs when insurers call the shots
May 8, 2026
Guest Blog: How MFN price controls could decide my health care
April 30, 2026
MFN price controls would drain pensions and put retirements at risk
April 23, 2026
States should avoid repeating the IRA’s price‑setting mistakes
April 21, 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
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
Insurers routinely block seniors’ access to medicines in Medicare Part D
March 18, 2026
MFN drug pricing risks reviving a harmful metric the U.S. rejected
March 16, 2026
Leadership in biopharmaceutical R&D provides U.S. patients the greatest access to innovative medicines
March 11, 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
CMS puts patients and innovation at risk with MFN
February 24, 2026
New list of selected drugs highlights growing consequences of government price setting
January 28, 2026
Price setting policies put cancer gains in jeopardy
January 16, 2026
Guest blog: Making the most of the Medicare Prescription Payment Plan
December 8, 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
PhRMA calls on USTR to ensure foreign nations pay their fair share
November 4, 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
Why states struggle to deliver savings: Middlemen and 340B siphon dollars from patients and states
September 15, 2025
Delivering breakthroughs and lower costs for patients
September 8, 2025
Celebrating 60 Years of Medicare
July 30, 2025
Medicare patients face higher drug costs, despite IRA promises
July 22, 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
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
New “Balance the Scales” campaign highlights why Americans pay more for prescription medicines
May 21, 2025
Foreign first pricing schemes don’t address why Americans pay more
May 15, 2025
New analysis: Fewer treatments and cures under the IRA’s pill penalty
May 1, 2025
How the IRA is impacting the generic drug market
April 8, 2025
Three reasons Congress should fix the IRA’s pill penalty
March 24, 2025
Improved treatments continue to lead to declining cancer mortality rates in the U.S.
February 25, 2025
CMS, don’t fall behind the rest of the medical community on obesity
February 14, 2025
Virginia, Don't Let Politicians Take Away Your Medicine
January 23, 2025
Patients are losing as government price setting continues
January 17, 2025
PhRMA CEOs Tee Up Next Week's Health Care Conference
January 11, 2025
A new administration poses new opportunities for patient access
December 17, 2024
Post-approval R&D is critical for fighting cancer. The IRA makes it more difficult.
November 13, 2024
CMS needs to do better
November 4, 2024
Is CMS paying attention to the growing access barriers for Medicare patients under the IRA?
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
Did the administration consider the importance of blood clot medicines to patients in the price setting process?
September 25, 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
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
Case study: How seniors could face access disruptions because of the IRA’s price setting provisions
July 22, 2024
PhRMA reiterates concerns with IRA price setting program, urges CMS to mitigate harm
July 3, 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: Health care policy should be driven by patients, not politics
June 10, 2024
ICYMI: Misaligned policies undermine patient access
June 6, 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
Government price-setting boards: Why Minnesota needs to take a better approach
May 9, 2024
Critics repeat same, misleading narrative on potential “costs” of new medicines
May 7, 2024
IRA is already negatively impacting access to medicines in Part D
April 25, 2024
Insurance data: PBM reform has no material impact on premiums
April 24, 2024
Government price setting won’t help patients in Illinois
April 22, 2024
New study finds insurers and PBMs increasing access restrictions in Medicare Part D
April 16, 2024
New analysis: Flawed assessments of a medicine’s value jeopardize patient access
April 11, 2024
What recent rhetoric on the cost of diabetes and anti-obesity medicines gets wrong
April 9, 2024
3 Takeaways from POLITICO’s Health Care Summit
April 3, 2024
ICYMI: More evidence of the IRA’s harmful consequences on post-approval research and development
March 25, 2024
Colorado is proof: Too many unanswered questions remain about state government price setting's impact on patients and providers
March 14, 2024
Watch: A conversation with Dr. Mike Ybarra on Rare Disease Day
February 29, 2024
American Heart Month: A nurse’s perspective
February 27, 2024
The truth about Nebraska's price setting push
February 13, 2024
Setting the Record Straight: Comparing U.S. drug prices to those in foreign countries hurts patients
February 7, 2024
As the administration continues to falsely claim Medicare “negotiation,” keep these points in mind
February 1, 2024
Powering the next generation of therapies: A conversation with Astellas US President Mark Reisenauer
January 30, 2024
When it comes to the future of innovation, the ball is in policymakers’ court
January 22, 2024
Biosimilars drive savings, but the IRA undermines their development
December 14, 2023
New analysis of patient access restrictions in the United Kingdom
November 21, 2023
The IRA’s pill penalty threatens the future of oncology R&D
November 16, 2023
Don't close the door on rare disease research
November 13, 2023
ICYMI: 3 takeaways on the IRA’s unintended consequences from America’s Physician Groups’ 2023 annual fall conference
November 6, 2023
R&D leaders to Biden Administration: Your policies are undermining the Cancer Moonshot
October 18, 2023
Three things economists are saying about the Inflation Reduction Act
October 11, 2023
4 truths about state government price setting
October 10, 2023
ICYMI: Government watchdog report finds patients in Medicare Part D paid billions more for medicines than insurers and PBMs
September 28, 2023
IRA threatens seniors’ access to robust treatment options
September 26, 2023
Medicare Prescription Payment Plan will benefit patients if implemented correctly
September 21, 2023
Correcting the record: IRA’s government price setting provisions are unconstitutional
September 8, 2023
IRA changes to Part D risk access to medicines
August 24, 2023
Three concerns about Colorado's approach to government price setting
August 23, 2023
With the first list of medicines out, let’s not forget why government price setting is bad policy
August 22, 2023
Michigan proposal jeopardizes access to medicines
August 21, 2023
One year later IRAs unintended consequences are becoming reality
August 16, 2023
AARP’s latest misleading report
August 11, 2023
New report: Hospitals mark up medicine prices 500%
August 2, 2023
read more
August 2, 2023
Key considerations as Congress works towards PAHPA reauthorization
July 12, 2023
New report shows high-impact R&D happens after cancer medicines are first approved
July 10, 2023
More than 60 researchers ask Congress to support innovation
June 26, 2023
New report shows how the Inflation Reduction Act stifles innovation for small molecule medicines
June 22, 2023
ASCO 2023: Protecting our progress in the fight against cancer
June 15, 2023
Highlights from ASCO 2023
June 8, 2023
Four things for CMS to keep in mind as they implement changes to Part D
June 7, 2023
Addressing Mental Health: A conversation with Barry Greene, CEO of Sage Therapeutics
May 30, 2023
Mental Health Awareness Month: Fighting the growing mental health crisis and supporting innovation
May 11, 2023
Insulin: Key Facts on Access & Affordability
May 10, 2023
4 key facts on medicine prices and spending
May 9, 2023
Support for continued progress is critical for pediatric drug development
May 8, 2023
New resource underscores the importance of small molecule medicines
May 4, 2023
Three facts about health care spending
April 25, 2023
CMS guidance on IRA price setting process doubles down on bad policy
April 14, 2023
A guide to MedPAC’s Part B vote today
April 13, 2023
New global analysis shows patient access challenges around the world
April 12, 2023
ICYMI: PhRMA President and CEO Stephen J. Ubl discusses patient affordability
April 7, 2023
MedPAC proposal threatens access to medicines in Part B
April 6, 2023
CMS coverage policy is detrimental to Alzheimer’s patients
April 4, 2023
How Part B’s ASP system helps control costs for the government and seniors
March 30, 2023
New Report: More than 400 medicines in development for leading chronic conditions affecting older Americans
March 28, 2023
Medicare Part B spending in four points
March 28, 2023
Celebrating the success of the COVID-19 vaccines, and looking to the future
March 27, 2023
IRA Impacts: Cancer treatment research and development
March 23, 2023
Celebrating 40 years of the Orphan Drug Act on Rare Disease Day
February 28, 2023
ICYMI: Cancer death rate continues to decline due to treatment advances
January 25, 2023
Novel medicines approved in 2022 offer increased treatment options for patients
January 23, 2023
ICYMI: PhRMA kicks off the year at the 2023 J.P. Morgan Health Care Conference
January 19, 2023
WTAS: Inflation Reduction Act already impacting R&D decisions
January 17, 2023
Study finds hepatitis C cure saved Medicaid $15 billion
January 5, 2023
ICYMI: PhRMA COO Lori Reilly speaks about the health care agenda for the next Congress
December 9, 2022
Medicare Part D open enrollment and what recent changes mean for beneficiaries
November 17, 2022
New data show how insurers and middlemen shift Rx costs onto patients
November 16, 2022
New government price setting policy threatens post-approval research
November 10, 2022
Many seniors are paying more for Part D medicines than their insurer
October 18, 2022
Busting 3 Myths About Copay Coupons
October 5, 2022
Rejecting ICER’s bad advice
September 9, 2022
CMS coverage policies restrict patient access to important treatment options for Alzheimer’s disease
September 1, 2022
Making coupons count for patients at the pharmacy counter
August 25, 2022
New survey: Voters seriously concerned about fine print in reconciliation bill
August 12, 2022
This week’s reading list: All the reasons the Senate-passed drug pricing bill is bad policy
August 10, 2022
Myth vs. Fact: The Senate’s latest price setting proposal
August 5, 2022
An open letter to Congress: Stand with patients and future cures
August 4, 2022
ICYMI: Patients across the country are sharing concerns about government price setting
August 3, 2022
The Senate’s latest price setting proposal will undermine U.S. economic growth
August 3, 2022
Celebrating Medicare’s 57th anniversary
August 2, 2022
New analysis finds deeper impact of drug pricing bill on biopharmaceutical researchers
August 1, 2022
ICYMI: A patient, physician, biotech investor and industry leaders warn about the dangers of government price setting bill
July 29, 2022
The Senate’s latest price setting proposal will undermine: Our health care system
July 28, 2022
The Senate’s latest price setting proposal will undermine: American medical innovation
July 27, 2022
The Senate’s latest price setting proposal will undermine: Patient access to medicines
July 26, 2022
The Patient Perspective: Government price-setting harms patients
July 22, 2022
New research shows competition driven by biosimilars helps control costs in Part B
July 19, 2022
Polling continues to show voters reject so-called Medicare “negotiation” once they learn about consequences for patients
July 12, 2022
By the Numbers: Patients lose when the government sets prices
July 8, 2022
Prescription drug prices are not fueling inflation
July 6, 2022
CMS coverage decision restricts access to treatments for Alzheimer’s disease
June 22, 2022
PhRMA warns of the growing influence of middlemen over patient access and out-of-pocket costs for patients
May 31, 2022
Report finds PBMs are increasingly restricting patient access to medicines
May 25, 2022
ICYMI: PhRMA CEO Stephen J. Ubl spotlights lessons learned during COVID-19
May 13, 2022
Annual projections from NHE compared to actual health care spending
May 5, 2022
Three charts show how the Medicare Part D program could be improved to work better for seniors and people with disabilities
April 27, 2022
What’s really happening when it comes to prescription drug costs
April 27, 2022
Part D 101: Three charts show how the program provides comprehensive prescription drug coverage
April 26, 2022
Analysis: States can help patients save nearly $1,000 annually on their medicines
April 21, 2022
New analysis confirms hospitals markup prices for oncology therapies
April 21, 2022
How standardized plans can improve patients’ access to medicines
April 18, 2022
Correcting the record: Putting medicine costs and spending in context
March 24, 2022
Sharing rebates can save Americans with diabetes 500 each year and improve adherence
March 16, 2022
Guest Post: If we truly want to cure complex diseases, politicians should reject price setting
March 14, 2022
Veterans Affairs 101: Three charts show how the VA system differs from Medicare
March 11, 2022
If drug prices are growing below the rate of inflation, why are patients still feeling the sting at the pharmacy?
March 8, 2022
Government price setting leaves behind families counting on new medicines
February 23, 2022
Part B 101: Three charts show the program helps control costs for health care system and enrollees
February 18, 2022