SarahRichterArt (

October 8, 2019; Bloomberg Government

You may or may not believe that pharmaceutical companies are behind the push for Trump’s impeachment, but they may be behind something much worse.

Last year, over and above the $27.5 million they spent on lobbying or advertising aimed at congress, drug companies, including AbbVie, Bristol-Myers Squibb, Merck & Co., AstraZeneca, Johnson and Johnson, and Pfizer, “contributed” more than $680 million to hundreds of patient advocacy groups and other related nonprofits. This was about twice what they donated in 2015, according to tax filings and data provided to the Senate Finance Committee.

Why so generous? Perhaps it has something to do with Congress’s current moves toward reducing the high cost of drugs. How can one overcome the image of greedy exploitation? Well, find a few willing nonprofits to front for the cause, maybe.

“It can be difficult for a drug company to go through the front door and argue their case,” Matthew McCoy, an assistant professor in the Department of Medical Ethics and Health Policy at the University of Pennsylvania, said. “It’s generally more effective to give money to patient organizations, which in general have a higher level of public approval than drug companies do.”

The nonprofit that’s garnered the most donations from the six companies over the past three years, the Patient Access Network Foundation, joined a list of patient groups writing in July to the Finance Committee warning of “unintended consequences”—such as making it harder for Americans to get certain medicines— of the panel’s proposal to make changes to Medicare’s prescription drug benefit program.

“As you well know, significant changes could alter the dynamics of the benefit, result in unintended consequences and create barriers that would affect beneficiaries’ access to Part D prescription drugs,” the groups said in the letter.

Some patient groups take pains to avoid any appearance the money they get from drugmakers influences their advocacy work.

Chris Wilson, the vice president for advocacy communications for the National Patient Advocate Foundation, said her group has scaled back some of its annual Capitol Hill visits in recent years after drug companies asked them to.

More than $81 million went into the coffers of the National Patient Advocate Foundation from the six drug companies over the past three years. The result? “The foundation recently backed Medicaid expansion in Virginia and fought against step therapy policies that require doctors to first prescribe medications specified by an insurer, typically generic, before they can prescribe certain, often high-cost, medicines.”—Ruth McCambridge