As midterms loom, Democrats on Congress’ Joint Economic Committee (JEC) are reviving concerns about the orphan drug carveout tucked into Republicans’ One Big Beautiful Bill Act, specifically lobbing allegations that President Donald Trump accumulated millions of dollars in pharma stocks before and after his administration and congressional Republicans enacted policies benefiting some of those same companies.
Central to the new report (PDF) are the JEC Democrats' findings that Trump increased his stock holdings in the pharmaceutical sector to as much as $56.2 million by the end of last year, up substantially from the maximum reported value of $1.7 million in 2024.
Moreover, the Democrats on the JEC contend that Trump held as much as $39.1 million in shares of Big Pharma companies last year that directly benefited from provisions in Republicans’ 2025 tax and spending law that weakened drug pricing reforms enacted under the Biden-era Inflation Reduction Act (IRA).
The companies themselves reaped at least $54 billion in reported 2025 U.S. sales of drugs that benefited from a specific provision in the One Big Beautiful Bill Act, known as the Orphan Cures Act, which exempts therapies with multiple rare disease indications from Medicare price negotiations established under the IRA. The JEC minority said in a separate release Friday that those sales represented a 13% increase from 2024.
Rather than improving affordability for seniors as advertised, the JEC argues that the One Big Beautiful Bill Act will instead increase costs for certain “commonly used” treatments covered by Medicare, citing examples such as AstraZeneca’s complement inhibitor Ultomiris, Pfizer’s Seagen-inherited lymphoma drug Adcetris and Merck & Co.’s immuno-oncology megablockbuster Keytruda.
Moreover, the negotiation-blocking carveout, which the JEC minority referred to several times as a Big Pharma “giveaway,” could also add around $9 billion to the federal deficit, according to a Congressional Budget Office estimate cited by the committee Democrats.
Apart from Ultomiris, Adcetris and Keytruda, the other six Medicare Part B drugs that the report estimates could cost seniors more because of the carveout are Bristol Myers Squibb’s anemia med Reblozyl and its oncology treatments Opdivo and Yervoy; Johnson & Johnson’s cancer drug Darzalex; Amgen’s Nplate for treating low blood platelet counts; and Roche’s Gazyva for leukemia and lymphoma.
The report’s appendix of Medicare Part B and Part D drugs that benefited more generally from the drug pricing carveouts is significantly larger.
In a statement issued alongside the JEC report, the committee's ranking member, Sen. Maggie Hassan, D-N.H., argued that the president and Republicans in Congress “intentionally force seniors to pay more for cancer treatment so that Big Pharma can rake in more money that Trump can personally profit from.”
Hitting back against the report, White House spokesperson Davis Ingle told Fierce that the president’s stock and bond portfolio is “independently managed by third-party financial institutions,” adding that all of Trump’s holdings “are maintained in discretionary accounts and invested through computer-based model portfolios that automatically replicate recognized indexes, such as the Schwab 1000.”
“Neither President Trump nor any member of his family has any ability to direct, influence, or provide input regarding how the portfolio is invested or when investments are bought or sold,” Ingle countered, asserting that all of the president’s investment decisions are made “entirely by independent managers” and that there are “no conflicts of interest.”
Meanwhile, on the matter of affordability, White House spokesperson Allison Schuster pointed Fierce to various recent initiatives from the administration to lighten the load on patients’ wallets, including “through his Most-Favored-Nation drug pricing agreements, distributing $500 Obamacare Refund checks, and increasing price transparency across the board.”
Citing the Council of Economic Advisers, the Trump administration has suggested that total savings from the president’s MFN deals could reach $600 billion over the next decade.
A closer look at the president’s financial disclosures analyzed in the JEC report shows that Johnson & Johnson topped the list of pharma holdings for 2025, when Trump reported a maximum stock value of a little over $12.85 million in the firm, up from just $182,000 the year before.
Similarly sweeping increases in maximum reported holdings were seen for Merck, Eli Lilly, AbbVie, Pfizer, Amgen, Gilead, Bristol Myers Squibb and Vertex, according to the report, which also identified a category of “other pharma companies” whose maximum reported value climbed from $194,000 in 2024 to $3.2 million last year.
Trump's portfolio continued buying and selling pharma stocks through the first eight months of 2026, the report asserts, with the committee estimating that his holdings increased by as much as another $3.5 million this year, not counting transactions yet to be disclosed from September.
The committee Democrats’ concerns dovetail with a much larger conversation about the apparent personal enrichment of the president, his family and his political allies during his second term in office, with a new poll out this week from the AP-NORC Center for Public Affairs Research finding that a majority of Americans surveyed, at 56%, believe he has prioritized his personal business interests “a lot” since retaking office.
Meanwhile, as fresh scrutiny is heaped on the Orphan Cures Act, which has been frequently decried as a Big Pharma concession by critics like the nonprofit Patients for Affordable Drugs Now, Trump has made his own push for drug price reform since returning to the White House while seeking to bring more biopharma investment into the United States through the threat of tariffs.
Those efforts are not without criticism of their own, with the most-favored-nation drug pricing deals the president has now struck with 26 large and midsized drugmakers drawing particular scrutiny over their lack of transparency.
Across the pond, another pharma-focused deal struck between the Trump administration and the United Kingdom may soon face greater scrutiny too, after the National Audit Office (NAO), the U.K.’s independent public spending watchdog, said it would begin preliminary inquiries into the costs and value of the agreement.
The broad strokes of the accord, which was finalized in April, include a pledge to increase the net prices the U.K.’s National Health Service pays for new medicines by 25%, in exchange for a 0% tariff rate on U.K. pharmaceutical exports to the United States.
But after several U.K. lawmakers started pressing for more clarity, NAO chief Gareth Davies wrote (PDF) on Sept. 30 that his team would begin preliminary inquiries into the arrangement, with further updates to follow once that initial work is complete.