Five years ago, a bipartisan bill that would have allowed Americans to order U.S.-made prescription medicines from Canada, where drug prices are much lower, went down to a bipartisan defeat despite widespread public support—just as it has every time the idea has been considered by Congress over almost two decades.

Knowing as voting began that he and the bill’s co-sponsor, Sen. Sherrod Brown (D-Ohio) would come up short, Sen. John McCain (R-Arizona) didn’t try to hide his contempt for what was unfolding:

“What you’re about to see is the reason for the cynicism that the American people have about the way we do business here in Washington. PhRMA (Pharmaceutical Research and Manufacturers of America), one of the most powerful lobbies in Washington, will exert its influence again at the expense of low-income Americans who will again have to choose between medication and eating.”

If John McCain said that about the pharmaceutical industry five years ago, one has to wonder what he must have thought when he heard this week that President Trump is nominating Alex Azar, a former drug company executive, to head the Department of Health and Human Services.


Tarbell’s first series of articles, which explores the extensive breadth and depth of that single industry’s influence in Washington—and which puts Azar’s nomination in historical perspective—couldn’t be timelier. Our reporting explains why, despite promises by politicians of both parties—including President Trump—to bring down drug prices, nothing that would do that gets enacted.

In a town of big spenders, Big Pharma is rarely ever outspent. Just three years before the McCain-Brown measure failed, the pharmaceutical industry spent $275 million on lobbying expenses to help shape what became the Affordable Care Act. That broke a record for the most money ever spent on lobbying by one industry in a single year. But, as Tarbell’s reporters explain, lobbying is just one of the many ways the pharmaceutical industry exerts its influence to keep its winning streak going for shareholders.

Our stories detail how the drug industry has built its powerful machine to protect corporate interests and keep medicine prices high. Tarbell pulls back the curtain on the mechanics of that power. We explain not only how the industry influences Congress through its army of lobbyists but also how it co-opts key advocacy groups and games drug laws and the patent system to protect its monopolies.

Credit: Emily Assiran | Philadelphia Magazine

PhRMA’s payments to advocacy and other groups are especially important gears of the industry’s well-oiled machine. Tarbell’s comprehensive review of tax filings found, for example, that PhRMA donated more than $14 million in 2015 alone to 300 organizations, including disease advocacy groups, think tanks, professional medical associations, universities and civic groups. Many of those organizations joined PhRMA and the National Health Council, funded primarily by pharmaceutical companies, in advocating for a bill the industry spent millions of dollars lobbying for and that Congress passed last December—the 21st Century Cures Act.

As you read the stories, you will see that our reporters contacted PhRMA and individual companies numerous times for information and comment. All of their requests were declined. That’s unfortunate but not unexpected. When possible and appropriate, we have included relevant statements industry representatives have made in the past.

You will find that that our approach to reporting on this issue—with a combination of investigative, explanatory and solutions journalism—is both innovative and actionable. The visual display of problems, details and solutions will empower readers to take action. Tarbell will also connect-the-dots between Big Pharma’s power and people’s lives, making this journalism accessible to audiences that lack health care expertise.

Know as you read these first Tarbell’s stories that they are just the beginning of our reporting on drug prices and the U.S. health care system. Also know that as we do not accept advertising, your financial support is vital to our success as a reader-funded journalism nonprofit. To see more stories like these, please make a tax-deductible donation today.