Trump’s Tax Law Reshapes Orphan Drug Policy, Slashes Medicaid, and Leaves PBMs Unchecked
SHERIDAN, WYOMING – July 8, 2025 – The newly signed One Big Beautiful Bill from President Donald Trump is poised to reshape the U.S. pharmaceutical policy landscape, restoring expanded orphan drug exemptions from the Inflation Reduction Act (IRA) while introducing significant Medicaid cuts and dropping regulatory reforms on pharmacy benefit managers (PBMs). The bill signals a strategic shift that may benefit the biopharma sector, while raising concerns about access and affordability in public healthcare.
Expanded orphan drug exemptions bolster rare disease R&D
Among the most consequential elements for the pharmaceutical industry is the reinstatement of broader protections for orphan drugs from Medicare price negotiations. The IRA had previously limited exemptions to drugs with only a single rare disease indication, but under the new law, those protections will now extend across multiple indications.