Six pharmaceutical manufacturers lost their final bid to overturn Medicare's authority to negotiate prescription drug prices when the Supreme Court declined to hear their cases, leaving intact a series of lower court rulings that rejected industry arguments.
The six companies — AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Novartis and Novo Nordisk — filed more than 10 lawsuits challenging the 2022 law that ended two decades during which Medicare was prohibited from negotiating drug prices. Courts across jurisdictions, including judges nominated by presidents of both parties, reached the same conclusion: there is no constitutional requirement allowing drug companies to avoid government price negotiations indefinitely.
For more than 20 years, Medicare could not negotiate lower prescription drug prices for Americans — a restriction that industry advocates wrote into law. This meant American patients paid significantly more for brand-name medications compared to patients in other wealthy countries where governments routinely negotiate pharmaceutical prices.
What the Right Is Saying
Pharmaceutical industry representatives and Republican critics of the law argue it amounts to government price controls that could stifle innovation. The Pharmaceutical Research and Manufacturers of America (PhRMA) spent nearly $38 million on lobbying in 2025, a 22 percent increase from the previous year, making drug pricing legislation a top legislative priority.
Industry advocates contend that allowing Medicare to negotiate prices sets a precedent for government interference that may discourage research and development into life-saving medications. They argue the market should determine drug prices rather than federal bureaucrats.
Some conservative critics have also raised concerns about the EPIC Act, which would extend from 9 to 13 years the exemption period for small-molecule drugs — accounting for roughly 90 percent of prescriptions — before they become eligible for price negotiations.
What the Left Is Saying
Patient advocacy groups and Democratic lawmakers say the Supreme Court's decision represents a major victory for consumers and Medicare beneficiaries. They argue the ruling validates years of patient advocacy that culminated in the 2022 legislation.
Merith Basey, CEO of Patients For Affordable Drugs, wrote that the court's refusal to hear the cases means reduced prices will continue for patients like Judy Aiken, a 72-year-old retired nurse from Portland, Maine, who previously paid more than $7,000 monthly for her medication and now pays approximately $2,300 under the negotiated rate.
Progressive lawmakers have called the program a long-overdue correction that puts American patients on equal footing with those in other developed nations. They point to data showing average price reductions exceeding 62 percent for the first ten drugs subject to negotiation.
What the Numbers Show
According to data cited by patient advocacy groups, nine million Medicare beneficiaries are receiving negotiated prices this year. The first ten drugs subject to negotiation saw average price reductions exceeding 62 percent, returning $1.5 billion to patients' pockets and saving taxpayers an estimated $6 billion in 2025 alone.
A second round of negotiations covering 15 additional drugs will bring lower prices to an estimated 5.3 million Americans starting in 2027. A third negotiation cycle is already underway. By the end of the decade, up to 60 high-cost medications are expected to be subject to price negotiations.
The EPIC Act, if passed, would extend small-molecule drug exemptions by four years, during which manufacturers could continue charging current prices without Medicare negotiation.
The Bottom Line
With their legal options exhausted, pharmaceutical manufacturers have shifted their strategy from courtrooms to Capitol Hill. The policy debate over Medicare drug price negotiation will now play out through legislation rather than lawsuits.
The Supreme Court's decision not to hear the cases signals that industry arguments challenging the program have failed to gain traction in federal courts. However, PhRMA's significant lobbying expenditure indicates the pharmaceutical industry intends to pursue its goals through congressional action.
What happens next: Congress will consider legislation including the EPIC Act and other proposals affecting when drugs become eligible for Medicare price negotiations. The outcome of these legislative battles will determine how quickly negotiated prices expand to additional medications and how many patients benefit from the program.