New polling suggests Americans increasingly see patent reform as key to lowering prescription drug costs and strengthening market competition — a shift with major implications for upcoming elections.
Prescription drug affordability has long ranked among Americans’ top economic anxieties. Voters now say that the cost of health care, rather than food or housing, is the top concern.
Recent public opinion data reveals something deeper is happening: voters are increasingly focused not just on prices at the pharmacy counter, but on the rules that shape how medicines reach the market in the first place. In fact, that shift could matter in the next round of federal elections, where health care costs consistently influence vote choice and candidate evaluations.
A national survey commissioned by the nonprofit Initiative for Medicines, Access, and Knowledge (I-MAK) and conducted by the Franklin & Marshall College Center for Opinion Research found broad, bipartisan support for patent reform aimed at lowering drug costs, and many prefer patent reform over direct government price controls.
The findings reinforce a growing pattern in public opinion: Americans want long-term systemic changes in order to address the problem of high drug prices and corporate greed.
A public that understands the structure
The survey suggests voters are not merely reacting emotionally to high prices — they are forming views about the mechanisms behind them.
About 90% of Americans support policies that would bring generic drugs to market faster, and 80% say brand-name medicines should face more competition.
Meanwhile, 84% believe drug companies make too much profit, and 82% recognize that Americans pay more than patients in other developed countries, in line with decades of consistent polling on the issue.
Taken together, these numbers point to an electorate that increasingly connects competition with affordability. This is a framing that moves the debate beyond short-term price relief toward the design of the pharmaceutical marketplace and the need for patent reform.
Research demonstrates that this connection is true in action. One analysis of top-selling drugs found an average of 140 patent applications and 74 granted patents per drug, with manufacturers often accumulating patent protections far exceeding the 20 year period under current U.S. patent law. These ‘patent thickets’ are then used to block or delay earlier competition that could significantly reduce drug prices sooner.
Voters understand that when market entry is delayed, prices stay high.
Voters are not anti-patent — but they are wary of abuse
Some industry groups have pushed back on reform narratives, with the argument that strong intellectual property protections remain essential for the development of biomedical inventions. A poll backed by the Bayh-Dole Coalition and cited by the Council for Innovation Promotion (C4IP) found large majorities of voters favor maintaining intellectual property standards intended to account for the time and expense required to bring medicines to market.
However, the poll raises methodological concerns: it frames policy proposals using charged language that could influence responses and has not been independently replicated or substantively analyzed by neutral media or academic polling experts. The lack of full transparency around question design and independent validation limits its usefulness as a neutral measure of public opinion.
Moreover, the results do necessarily demonstrate opposition to patent reform. Expressing support for intellectual property protections in general does not equate to rejecting reforms aimed at preventing extended monopolies or practices beyond what lawmakers and the public originally intended. As a result, the suggested conflict by industry groups between public support for patent protection and efforts to better regulate the patent system are likely overstated.
The political stakes
Prescription drug prices in the United States remain among the highest globally, with prices three times higher than in 33 high-income countries. The survey revealed that one quarter (26%) of adults said they did not fill a prescription in the past year because of the cost. Among those who have taken a prescription drug in the past year, one in three (31%) said they did not fill at least one prescription because of the cost.
Those realities help explain why affordability repeatedly rises to the top tier of voter concerns in national polling.
Patent reform occupies an unusual space politically because it can appeal simultaneously to:
- fiscal conservatives focused on market competition
- progressives/left-wing voters concerned about corporate power
- older voters managing chronic conditions
- employers absorbing rising health costs
Few health policy topics offer that breadth of coalition.
A reframing underway
Perhaps the most important takeaway from the survey data is conceptual rather than only statistical.
The debate is shifting from “Why are drugs expensive?” to “What market conditions allow them to stay expensive?”
For legislators and voters, this distinction matters: price caps can provide immediate relief but often trigger ideological fights about government intervention. Reforms curtailing monopolies and corporate power can be framed as reinforcing competitive markets — an argument historically more durable across policymakers’ diverse ideologies. In other words, there is a prime opportunity for lawmakers to address the abuses of the patent system to make an immediate impact that will last for generations. This includes common-sense solutions identified in I-MAK’s blueprint for affordable drug prices, created from participatory changemaking sessions with stakeholders impacted by policies.
For policymakers, the signal is that voters are ready for technical conversations about patent reform once considered too complex for campaign messaging. Furthermore, the survey reveals that the public is capable of engaging with the architecture of the patent system, not just its downstream outcomes.
What this means for the 2026 midterm elections
There are a number of policy solutions that would help improve the integrity of the patent system while also providing tangible benefits for voters. These include:
- Proposals aimed at improving transparency, such as a mandatory requirement for drugmakers to provide the U.S Patent and Trademark Office (USPTO) and U.S. Food and Drug administration (USFDA) with all patents and patent applications they own or license relating to a product, and make that information available to the public.
- Redefining what “novel” inventions are and what is deserving of a patent. Currently, the USPTO’s standards for determining whether a claimed invention in a patent application is “novel” and “non-obvious” are too low and do not reflect common general knowledge routinely practised in the pharmaceutical sector.
- Investigations into pricing dynamics as set by pharmaceutical companies at the outset of the drug supply chain and not just on pharmacy benefit managers (PBMs), which do not set the initial prices.
The pharmaceutical sector and its allies have increasingly framed patent reform as a threat to intellectual property itself. However, the goal is to actually return integrity to the patent system that has been stretched well beyond its intended limits in order to maximize the profits of the pharmaceutical industry and its shareholders at the expense of the public.
Voters appear to be parsing that distinction more carefully than the political rhetoric might suggest. As affordability continues to dominate at the ballot-box, the candidates who best understand that nuance — structural change that addresses corporate monopoly power and not just cheaper prescriptions or incremental cost savings — may hold the advantage.
For more, read this Politico Focus feature on how we can design a blueprint for affordable drug prices.