Hawley Puts Big Pharma on Notice, Unveils Two New Bills in Patients First Agenda to Cut Drug Costs

Wednesday, April 19, 2023

Today U.S. Senator Josh Hawley (R-Mo.) unveiled two new bills in his Patients First Agenda to Cut Drug Costs. In addition to Senator Hawley’s already-introduced Cap Insulin Prices Act, the agenda includes the Fair Prescription Drug Prices for Americans Act and the Ending the Prescription Drug Kickback Act of 2023

If enacted, his three-part agenda will together target the biggest abuses in the prescription drug market to reduce costs for patients.

“Our prescription drug market is rigged in favor of Big Pharma and Big Insurance and patients are paying the price. Americans foot the bill for the most costly prescription drug prices in the world—all while middlemen negotiate backroom deals to extract financial kickbacks that drive prices further up and prevent lower-cost alternatives,” said Senator Hawley. “These conditions inflate prices, strain the budgets of American families, and create unacceptable barriers to care. It’s time to stop subsidizing lower drug costs for foreigners, end Big Insurance’s pay-to-play scheme, and put American patients first.” 

The Fair Prescription Drug Prices for Americans Act would:

  • Prohibit pharmaceutical companies from selling a drug in the United States at a higher price than the average price of the drug sold in the other G-7 advanced economies. 
  • Impose stiff civil monetary fines for Big Pharma if they sell a drug at a higher list price in the United States than the average price of the drug sold in Canada, France, Germany, Japan, Italy, and the United Kingdom.


The United States pays, by far, the highest prescription drug prices in the world, oftentimes paying two to four times more for the same medication than other nations with advanced economies.

Pharmaceutical companies benefit greatly from America’s robust intellectual property protections, monopoly-status exclusivity periods, and preferential tax treatment—policies that have brought countless prescription drugs to market to the benefit of patients in the United States and across the world. However, as a matter of basic fairness, it is unacceptable that American patients and American taxpayers should be forced to further subsidize Big Pharma by paying more for the same drugs than patients in other nations.

View the full bill text here

The Ending the Prescription Drug Kickback Act of 2023 would:

  • Entirely prohibit, without exception, prescription drug rebates in both federal health programs like Medicare and private insurance plans, including those intended to influence formulary tier placement or its equivalent.
  • Restore transparency and fairness to the prescription drug market and put patients on a more level playing field with large corporations.


For years, Big Insurance has gotten a sweetheart deal from Big Pharma.  Pharmacy benefit managers (PBMs) negotiate prices with drug companies on behalf of health plans. They negotiate “rebates” from drug companies in exchange for favorable coverage of a company’s drugs in health plans—even if cheaper or better alternatives exist. 

It’s a sweet deal for Big Insurance, but terrible for patients. It creates a pernicious pay-to-play negotiating dynamic that incentivizes Big Insurance and PBMs to prioritize the value of their kickbacks over the clinical value of the drugs they cover and the total costs paid by patients. Congress must act to ensure that prescription drug markets are more transparent and less susceptible to distortions that place profits over patients.

View the full bill text here