Americans have been clamoring for sensible prescription drug reform for years. With the stroke of his pen, President Donald Trump answered that call.
His executive order aims to bring down drug prices while "once again putting Americans first." Luckily, it specifically addresses one of the serious flaws in the Biden administration's Medicare Drug Price Negotiation Program — an oversight that has discouraged investment in affordable, widely used medications.
This reform could deliver major savings to patients — without undermining the innovation that drives medical breakthroughs. Now it's up to Congress to finish the job.
The reform in question addresses a flaw in the Medicare price-setting scheme put in place by the 2022 Inflation Reduction Act.
That law gave the secretary of Health and Human Services sweeping new authority to impose price controls on certain drugs covered by Medicare. But it also drew an arbitrary line between different types of medicines by giving biologics, which are made from living organisms,13 years before price-setting kicks in, while small-molecule drugs, like pills and capsules, get just nine.
That four-year gap makes no clinical or economic sense. Many of the most important drugs in history, from aspirin to statins to HIV treatments, are small-molecule medicines. Yet innovators are now steering investment away from them. According to a recent study, investment in small-molecule drugs has already dropped by 68 percent. And compared to pre-IRA levels, new small-molecule cancer drug development programs fell over 40 percent last year.
President Trump's order calls for correcting this imbalance. The Republican-backed EPIC Act offers the clearest solution, aligning the treatment of small-molecule drugs with biologics by extending the price-setting window to 13 years. My hope is that this legislation will pass quickly with bipartisan support.
Passing EPIC would protect innovation, preserve patient access and deliver on the president's promise to fix what the last administration got wrong.
The order also directs the secretary of Labor to write new transparency rules to address some of the other significant issues affecting drug access and prices. That’s a big win for patients and a critical step toward restoring fairness to the system and decreasing out-of-pocket costs for Americans.
In addition to these transparency reforms, the order acknowledges the critical role of intellectual property rights in bringing new drugs to patients — and promises to optimize those protections in ways that improve access and lower drug costs.
Patents and other intellectual property protections play a central role in pushing medical science forward. The previous administration's efforts to undermine these essential tools posed a direct threat to the foundations of America's innovation-driven economy. President Trump's unequivocal stance on this issue should come as welcome news to the nation's inventors and entrepreneurs — including those in the biotech sector.
Equally encouraging is the executive order's treatment of the 340B Prescription Drug Program. The program was originally designed to help safety-net providers offer affordable medications to low-income patients. Yet today, less than 40 percent of hospitals that use the program are in underserved areas. During my time in Congress, I took up this issue — championing reforms to promote transparency, increase accountability and require participating hospitals to report patient’s benefits.
Now, emboldened by the White House, lawmakers should do the same.
Altogether, this order is a blueprint for drug pricing reform that's patient-focused, pro-innovation and rooted in real-world solutions. Now, Congress can do its part, beginning with passing the EPIC Act.
If they do, American patients could finally get the kind of affordable, innovative and equitable prescription drug sector they've long demanded.
Larry Bucshon, MD, a cardiothoracic surgeon, served as the U.S. representative for Indiana's 8th District from 2011 to 2025.
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