not used title

not used title

Members of Congress continue to push a misguided drug pricing proposal under the guise of negotiation as part of the reconciliation package. This proposal is nothing short of government price setting and, if implemented, would require the government to dictate prices and choose winners and losers when it comes to which diseases are likely to see new treatments. Instead of addressing a broken insurance system, the most recent proposal doubles down on bad policies that will threaten patient access to medicines and future innovations. This is the first blog in a three-part series where we discuss the very real threats of the proposal.

The latest Senate reconciliation package undermines:

• Access to medicines
• Innovation for lifesaving medicines
• The health care system

The threat to access.

• This policy threatens patient access to future medical advances. The drug price-setting provisions in the reconciliation package are projected to cause an immediate decline in research and development (R&D) spending, resulting in fewer new medicines coming to the market in the future. By some estimates, proposals in the reconciliation package could sacrifice more than 100 new treatments over the next two decades. This shouldn’t be a surprise to anyone. History shows that when foreign governments have set the price of medicines, R&D investment and innovation have greatly declined because governments choose which diseases are worth investing in and which are not. When you consider that there are hundreds of medicines in development today for unmet needs like Alzheimer’s and childhood diabetes, you’re left wondering: Which diseases will be left untreated if this bill passes?
  
  
• This policy jeopardizes access to today’s medicines for Medicare Part B patients. The latest drug pricing plan would change how doctors who administer Part B medicines are paid. Under the new system, if implemented, doctors would be reimbursed based on the much lower government-set price instead of the market-based price used today. Sounds simple but it isn’t just a small change, it’s an average reduction of nearly 40%. That could be the difference for some doctors of whether they can afford to administer certain medicines or not. And for rural providers, that could be the difference between whether they can keep their doors open or not. Either way – it means many seniors have less access and have to potentially travel further for care.
  
  
• This policy could undermine the success of Medicare Part D. The Part D program relies on competition to control costs and provide seniors with the ability to choose the plan that best fits their needs. This power to choose is hugely popular among seniors. Despite this, the latest drug pricing plan will upend Part D, eroding the program’s successful foundation of competition and choice. Today, Part D plans compete against one another and negotiate discounts from manufacturers as part of this competition. But in a world where the government sets the price of Part D medicines, there is less incentive to compete to cover other medicines in the same class. This is likely to lead to more standardized Part D plans and fewer plan options for seniors to choose from.

Learn more about why government price setting is bad policy and better ways Congress could help patients access and afford their medicines. Stay tuned for our next blog in this series when we discuss how price setting will undermine innovation.

Take action: Tell Congress to protect access to new medicines.

Nicole Longo

Nicole Longo is Deputy Vice President of public affairs at PhRMA focusing on Medicare, 340B, importation and more. She previously worked for a D.C.-based public affairs firm where she assisted a wide range of clients with communications efforts on everything from trade policy to agriculture policy to health care policy. Outside the office, Nicole can be found trying new restaurants (usually Italian), taking an occasional barre class and cheering on the Cincinnati Bengals.

Nicole Longo

Author Twitter

Author LinkedIn

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

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

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

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

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

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

Biopharmaceutical innovation for a healthier America: PhRMA releases new innovation report

February 21, 2025

New policy agenda charts solutions for a healthier America

February 20, 2025

A successful PhRMA Forum highlights our commitment to a healthier America

February 20, 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

Post-approval R&D is critical for fighting cancer. The IRA makes it more difficult.

November 13, 2024

Reimagining patient access through meaningful policy reform

November 5, 2024

CMS needs to do better

November 4, 2024

New PES survey: Out-of-pocket costs lead key health care priorities ahead of the November election

October 30, 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

WTAS: Voters voice concerns about PBM abuses, call on policymakers to act

July 19, 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

Ongoing federal probes shed light on PBM and insurer practices

May 20, 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

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

ICYMI: Voter priorities this election season

April 18, 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

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

Four years later, Maryland board still hasn’t delivered for patients

February 12, 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

ICYMI: When middlemen get in the way, it’s the patients who lose

December 5, 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

ICYMI: WSJ — Same Drug, Two Prices: Why the Higher Price Prevails

November 15, 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

One year to Election Day: Four voter priorities to watch

November 6, 2023

ICYMI: Scott LaGanga and Matt Salo deliver a State of the Industry Report

October 25, 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

Word of the Month: AMR

September 27, 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

New analysis shows PBMs use fees as a profit center

September 18, 2023

Correcting the record: IRA’s government price setting provisions are unconstitutional

September 8, 2023

New PhRMA ad exposes yet another way PBMs get between patients and their medicines

September 5, 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

Three things to know from the latest Patient Experience Survey

July 20, 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

ICYMI: PBM exec admits choosing profits over patients

June 2, 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

4 key facts on medicine prices and spending

May 9, 2023

Support for continued progress is critical for pediatric drug development

May 8, 2023

4 Things to know about PhRMA’s new 50-state poll

May 4, 2023

New resource underscores the importance of small molecule medicines

May 4, 2023

Americans want state policymakers to lower out-of-pocket costs

May 1, 2023

Policies need to address the growing threat of antimicrobial resistance

April 28, 2023

Three facts about health care spending

April 25, 2023

AHIP’s latest misinformation campaign & what it’s trying to hide

April 24, 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

States can support access to medicine as COVID-19 Public Health Emergency ends

April 5, 2023

Arkansas puts patients first with new share the savings law

April 4, 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

Key Trends: Patient experience data reveal how insurers and middlemen impose barriers in health care

March 29, 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

Holding pharmacy benefit managers accountable

February 23, 2023

Stopping pharmacy benefit managers from “gaming the system”

February 22, 2023

Senate hearing to examine bipartisan reforms to rein in middlemen

February 16, 2023

Minnesota lawmakers are letting PBMs off the hook, and threatening patients’ access to medicines

January 31, 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

ICYMI: PhRMA COO Lori Reilly speaks about the health care agenda for the next Congress

December 9, 2022

In their own words: Financial barriers exacerbate access challenges for insured Americans

December 8, 2022

Putting Delaware patients first: Protecting Patient Assistance Programs

November 22, 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

In their own words: Insured Americans struggle to navigate complex coverage

October 26, 2022

Many seniors are paying more for Part D medicines than their insurer

October 18, 2022

Biosimilar uptake is increasing and so are health savings

October 17, 2022

New comments outline ways to protect patients from health plans and PBMs who profit from patient assistance

October 7, 2022

Busting 3 Myths About Copay Coupons

October 5, 2022

Mental Illness Awareness Week – A time for reflection

October 3, 2022

A key fact the White House is reluctant to admit

September 27, 2022

A key fact the White House is reluctant to admit

September 27, 2022

Navigating the patient experience: Burdens and barriers standing between patients and their care

September 12, 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

Making coupons count for patients with HIV

August 8, 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