| (A big thanks to Washington Post Intelligence graphics reporter Daniela Santamariña for the lovely chart.) → You can set your clock by it: PhRMA, the main industry group for larger drugmakers, is once again the top spender on lobbying. The association didn’t comment on the bump — but it’s been a busy year for the industry that’s had to grapple with how to manage its relationship with the new administration, in addition to continuing its big-dollar advocacy push to reform the 340B discount drug program. → The GOP-led domestic policy bill that enacted sweeping cuts to Medicaid and the looming expiration of the Obamacare tax credits have energized AHIP, which represents a swath of health insurance companies. Although its lobbying for the year thus far is up 43 percent compared with the same time in 2024, its efforts to push lawmakers to extend those tax credits ramped up in recent months. That contributed to the $4.2 million in lobbying spending during the third quarter, a 65 percent increase over the same period last year. → Trump sent letters to 17 large pharmaceutical companies on July 31, ordering them to make deals with the administration to impose so-called most favored nation pricing agreements on their products, lowering the cost to match other wealthy countries. Eleven of the 17 companies increased their lobbying spending during the third quarter — smack dab in the most-favored-nations negotiation time frame. Part of what drives these increases, I’m told, is an increased involvement from more senior-level people at these companies. Pfizer, the first company to announce a deal at the White House on Sept. 30, spent nearly $10.7 million in the first three quarters of the year — including spending more than $2.7 million from July through September, a 155 percent increase over the same period in 2024. The second company to announce it had cut a deal with the administration, AstraZeneca, spent more than $4.4 million to lobby the federal government in the first nine months of 2025 — including roughly $1.4 million during the third quarter, more than double what it spent during the same time last year. The U.K.-based drugmaker spent just $2.3 million on lobbying in the first nine months of 2024. Gilead, another company that received a letter but has yet to announce a drug pricing pact with the White House, spent about $2.8 million on lobbying from July through September this year — a 36 percent increase over the same time last year. Among the major items in its advocacy portfolio this year: Working on an agreement with the State Department to bring an injectable HIV prevention to low-income countries at cost — meaning it will make no profit from providing the antiretroviral injection. → Some of the large increases this year are a result of companies investing in having a greater Washington footprint — bringing on their own in-house staff. Telehealth company Hims & Hers now has lobbyists of its own, in addition to the ones the company has on contract to lobby on its behalf. Its roster features pharma industry alum Sonya Elling, who joined the company in February, and Whitney Jones, a former health analyst for the Senate Republican Policy Committee, who came on board in July. Adding the two in-house lobbyists this year represents Hims gaining its footing in Washington, as it battles with pharmaceutical companies over the compounded versions of GLP-1 weight loss medications — and grapples with a Food and Drug Administration that wants to crack down on medication ads targeting patients. Hims spent $860,000 on lobbying in the first three quarters of this year, a 231 percent increase over the same time in 2024. The most recent disclosure forms mention the company lobbied on telehealth rules involving the prescription of controlled substances and legislation related to compounding and drug advertising. | 
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