Please fix the “pill penalty” to help protect patients
Dear [Legislator],
Please pass [H.R. 1492/S. 832] to fix the IRA’s dangerous “pill penalty.” Patients can’t afford to wait any longer and risk feeling the devastating consequences of the misguided pill penalty policy.
The pill penalty allows the government to select small molecule medicines, which come in pills and capsules, for price-setting as early as seven years after the medicines are approved by the FDA, with the set price taking effect two years later—only nine years after the medicine was initially approved. But the current average time frame is 13–14 years before generic competitors typically emerge, setting up a system that could discourage investment in the development of small molecules, or pills, and risks leaving patients without the treatment options they desperately need.
Fixing the pill penalty would help incentivize cancer research. A quarter of new uses for small molecule cancer drugs are identified more than nine years after their initial approval. Pills are also more accessible and easier for patients to take – 90% of cancer patients would choose pills.
(1) Small-molecule drug funding has already dropped 70% since legislation that would become the IRA’s drug pricing provisions was first drafted in September 2021.
(2) Please fix the pill penalty before patients feel the ripple effects on the development of treatments and their access to medicine!
Thank you,
[Advocate name]
1 https://phrma.org/resources/2025-policy-agenda-solutions-for-a-healthier-america