A major consumer advocacy organization began consistently criticizing foes of pharmaceutical manufacturers after the industry’s top trade association directed large donations its way, a Washington Examiner review of public records has found.
The National Consumers League, America’s oldest consumer advocacy organization, accepted no funding from Pharmaceutical Research and Manufacturers of America between 2018 and 2019. PhRMA, however, started cutting large checks to NCL in 2020, which a review of the organization’s web pages shows coincided with an explosion of criticism aimed at pharmacy benefit managers and the 340B drug pricing program — both longtime enemies of the drug industry.
PhRMA donated roughly $2 million to NCL between 2020 and 2024, including $875,000 in 2024 alone. NCL web pages indexed by Google show no critical mention of PBMs or the 340B program prior to 2020, with critical mentions beginning to appear after that point and becoming increasingly common from 2024 onward.
Archived web pages, for instance, show that NCL updated the “health” section on its website to feature its campaigns against the 340B program and PBMs prominently sometime around May of this year. Prior, the page had only featured the NCL’s “Script Your Future” campaign, which sought to educate consumers on the importance of adhering to medication regimens as prescribed by healthcare professionals.
NCL’s campaigns against the 340B program and PBMs employ similar rhetoric to that used by PhRMA itself.
PhRMA, for instance, characterizes PBMs as “middlemen” who “refuse to share savings with patients.”
NCL, meanwhile, adopts a similar approach by accusing PBMs, which are supposed to negotiate lower drug prices by representing large pools of consumers and leveraging their collective purchasing power, of being “middlemen” who enrich themselves with the savings they negotiate, which come in the form of rebates paid by manufacturers, while failing to pass on savings to consumers.
On 340B, an initiative run by the Health Resources and Services Administration that requires pharmaceutical manufacturers to provide discounted outpatient medications to certain healthcare providers in impoverished or rural areas, PhRMA argues that hospitals use it to “purchase medicines at prices that can be as low as a penny” only to turn around and “mark up medicines by thousands of dollars” thus failing to pass on savings to patients.
Again, NCL takes a similar line as PhRMA, arguing that the program, though well-intentioned, falls victim to abuse from hospital systems that sell the discounted drugs at exorbitant prices, thus undercutting its purpose.
“We engage with different groups who have a wide array of different policy opinions and priorities,” PhRMA Senior Vice President of Public Affairs Alex Schriver told the Washington Examiner. “We may not agree on every issue, but we believe engagement and dialogue [are] important to promoting a healthcare policy environment that supports innovation, a highly-skilled workforce, and access to life-saving medicines.”
Other materials published by NCL since 2020 criticizing PBMs and the 340B program include a flood of blog posts, statements seeking to push Congress toward reform, joint letters with other organizations seeking policy changes, a multitude of infographics, numerous podcasts on the subjects, policy briefs, and solicitations to citizens seeking negative anecdotes about the 340B program, among other pieces of media. NCL, given its long history and accumulated goodwill with citizens and policymakers alike, is a valuable ally for the pharmaceutical industry.
Altering either the 340B program or the regulations surrounding PBMs could boost profits for drug manufacturers. The former forces them to sell their drugs at a discount, thus harming profitability. Tweaking PBM regulations by forcing greater transparency, meanwhile, could force PBMs to demand lower rebate payments from manufacturers, lowering expenses considerably for the pharmaceutical companies represented by PhRMA.
PhRMA, in fact, has a long history of paying top dollar in an attempt to spur PBM reform.
Previous reporting from the Washington Examiner and other outlets has found that many of the organizations bankrolled by PhRMA push messaging critical of PBMs. The Wall Street Journal reported in April that the pharmaceutical industry had spent millions of dollars funding political groups and advertisements that attacked PBMs, on top of tens of millions of dollars more in lobbying expenditures, in 2024.
“The National Consumers League is guided by one principle: protecting consumers,” a spokeswoman for the organization told the Washington Examiner. “Our work on the 340B program is driven by the reality that PBMs and large hospital systems and pharmacies they work with are walking away with billions of dollars that are supposed to help patients access affordable medicines … Like many nonprofits, we partner with a broad range of stakeholders — including industry, consumer organizations, nonprofits, healthcare professionals, and patient advocacy groups — when their support advances meaningful consumer education and protections.”
The spokeswoman went on to argue that both PBMs and the 340B program have failed to make healthcare cheaper due to a lack of transparency, monopoly dynamics, and greed from hospitals, which she says motivates NCL to cover the two issues.
“NCL receives support from a diverse set of stakeholders, and our policy positions are our own,” the spokeswoman continued. “We retain complete editorial control over all content, and our agreements explicitly safeguard that independence.”
Prior to 2018, PhRMA made smaller donations to NCL, including $125,000 in 2017 and $20,000 in 2016. Only after the lull of donations between 2018 and 2019 and their subsequent return in 2020, however, did NCL come out in force against PBMs and the 340B program. NCL did not deny in their statement to the Washington Examiner that their scrutiny of PBMs and the 340B program intensified from 2020 onwards. They did, however, confirm that contributions from PhRMA support its “healthcare work.”