The Pill Penalty

A flawed policy in the Inflation Reduction Act known as the “pill penalty” discourages investment in pill-based medicines—threatening patient access, innovation and affordability.

The IRA’s Pill Penalty Harms Patients

The “pill penalty” is a policy in the Inflation Reduction Act that subjects pill-based medicines to government price setting years earlier than other treatments. It discourages investment in innovation for pill-based treatments and fails to address the real drivers of high costs, like PBMs and 340B hospitals. That means:

  • Less investment in developing medicines that come in pill form
  • Fewer treatment options and more barriers to care for patients
  • Higher out-of-pocket costs for seniors as PBMs and insurers shift costs to patients


We’re already seeing the impact: investment in pill-based medicines has dropped nearly 70% since the IRA was introduced, putting future innovation at risk.

“The pill penalty is causing more harm than good. It’s not about politics. It’s about people. Cancer doesn’t care if treatment comes in a pill and neither should Congress.”Terry, Patient Advocate & Colon Cancer Survivor

What Congress Can Do

Congress has a bipartisan fix on the table: the EPIC Act (Ensuring Pathways to Innovative Cures Act). This legislation would level the playing field between small molecule pills and biologic treatments. That means:

  • More investment in small molecule medicines like pills that are convenient for patients.
  • More affordable options for patients.
  • Continued progress on treatments for cancer, mental health, cardiovascular disease, and more.

Take Action

Tell Congress: support the EPIC Act, a bipartisan bill that would fix the pill penalty, protect patient access and fuel the next wave of medical innovation. Because better policy means better treatments, for all patients.

Advocate Voices

Advocates are speaking out to protect access to pill-based treatments.

Protect Innovation, Preserve Dreams of Parenthood: The McDonnell’s Story

Terry’s Story: Innovation Supports Patient Access