Original air date: December 14, 2025

Many political leaders promise to lower drug costs, but few, if any, ever achieve the goal. During his term, President Biden signed major legislation allowing the government to negotiate lower prices directly with drug companies; meanwhile, President Trump recently promised major savings for patients. But as Lisa Fletcher reports, a new analysis of recent government moves shows in some cases, drug costs are actually rising.

The following is a transcript of a report from “Full Measure with Sharyl Attkisson.”
Watch the video by clicking the link at the end of the page.

When Democrats passed President Biden’s Inflation Reduction Act in 2022, it came with a high price tag and a big promise.

Biden: We’re giving Medicare the power to negotiate those prices now, on some drug. This means seniors are going to pay less for their prescription drugs.

The idea: that, for the first time, the federal government would negotiate drug prices directly with drug companies.

The aim to lower costs, both for taxpayers and medicare patients.

Medicare provides healthcare for 67 million adults, mostly seniors.

The program cost taxpayers $1.12 trillion last year, of which more than 220 billion was spent on prescription drugs.

Like $12.6 billion on the blood thinner Eliquis, $4.7 billion for the diabetes drug Trulicity and $3.2 billion for Imbruvica, which treats cancer

But a catch is already emerging in the Biden plan designed to lower costs.

Bill Smith: Policymakers really do not understand how the drug markets work. They simply don’t. And they’re legislating based on these profound misunderstandings of how things work

Bill Smith is a health policy expert with the Pioneer Institute in Boston, a public policy think tank.

He’s been tracking drug prices since the law passed and noticed a trend with out-of-pocket costs — the cash that patients pay upfront at the pharmacy.

His study finding for most of the 10 drugs the government negotiated lower prices for, costs for patients have started to rise significantly, even before the new negotiated prices come into effect.

Bill Smith: I think the biggest surprise was that out-of-pocket costs were up 32%. The government should be embarrassed by this.

So why are costs for patients going up instead of down?

Middlemen companies called Pharmacy Benefit Managers or PBMs usually negotiate drug prices for medicare patients. But, Smith says, with the government cutting out the middlemen for lower costs, the middlemen are finding ways to charge more elsewhere to keep the profits rolling in.

Bill Smith: So the way to make it up is to charge seniors more out of their pocket. We finally beat the pharma companies, is what President Biden said. Well, the seniors are the ones that got the short end of the stick here, and they were supposed to be the ones that were helped.

Smith showed us what’s happened with Eliquis, a popular drug used to treat and prevent blood clots

Bill Smith: This is Eliquis in all four PBMs, the average out-of-pocket costs went from $77.99 cents to $106.10 across all four PBMs.

Smith says PBMs are likely padding their balance sheets by raising out-of-pocket charges now, anticipating lower revenue when the drug cost controls start next year.

While direct drug price negotiation passed under President Biden, Trump has also made lowering prescription costs a priority.

He signed an executive order to tie the price of drugs in the US to the lowest prices paid in other developed countries.

In early August, the president proclaimed incredible savings.

Trump: You know, we’ve cut drug prices by 1200, 1300, 1400, 1,500%.

The White House later clarified Trump was talking about future savings.

Health Secretary, Robert F. Kennedy Jr. now tasked with making drug makers who are bitterly opposed, comply with the president’s demands

Robert F. Kennedy Jr: We’re in negotiations right now with the pharmaceutical companies and we are going to pay the same, at the end of this, as people pay in Europe and other nations.

According to Bill Smith, the lesson to take from President Biden’s effort to lower drug costs is that it is much harder than it seems.

Lisa: So what effect has the Biden plan actually had on drug prices?

Bill Smith: Well, the government is going to pay less because the list price has dropped. But unfortunately, senior citizens who are on Medicare are going to pay more out of pocket because the rebates declined.

2026 will prove whether the efforts of Presidents Biden and Trump can finally start to bring drug prices down.

For Full Measure, I’m Lisa Fletcher in Boston.

Watch video here.