The prices of drugs developed with federal funding have received a significant amount of political attention. In 1980, Congress passed legislation to encourage companies to commercialize inventions developed with federal funding by expanding opportunities for private companies to obtain exclusive rights over those inventions. At the same time, it gave agencies powers to oversee how companies use the exclusive rights. Recently, drug pricing reform advocates have used these public oversight tools as hooks to push for political change.
Federal funding is not the only way that the federal government supports drug development, though. Since 1980, Congress has created numerous other incentives to encourage companies to develop new drug products, ranging from Medicare subsidies to tax credits to patent protections and regulatory exclusivities. Yet Congress has created few structures for public oversight of these other public investments in pharmaceutical innovation.
This Article argues that Congress should create more public oversight structures for pharmaceutical regulation. Public accountability is crucial to allow both regulators and the public to oversee whether public investments are serving policy goals such as providing broad access to socially valuable new medicines. The existing legislative framework, however, leaves drug pricing decisions largely to the discretion of private companies with little public information about how various regulatory incentives interact to influence drug development. As a first step, Congress should require more centralized disclosure about how public investments contribute to individual drug products. Increased transparency on a drug-by-drug basis could help inform innovation policy debates and galvanize political support for further substantive drug pricing reform.
Volume 174 Issue 5 2026 Article Health Law;