The affordability crisis hitting Missouri households isn’t an accident. It’s a business model. American households are making impossible choices: groceries or insulin, rent or a blood pressure prescription, a child’s asthma inhaler or the electric bill.

These aren’t hypotheticals. These daily realities are taking a toll onMissouri families. Over the past decade, the cost of life-saving medications has risen steadily, with U.S. prices far outpacing those in comparable countries and continuing to exceed inflation year after year. Unjustified price hikes are not a side effect of the pharmaceutical business model. They are the pharmaceutical business model.

What’s worse – while families continue to navigate affordability issues strangling their household budgets, Big Pharma executives are doing just fine.

The five highest-paid pharmaceutical CEOs in America took home a combined $157.8 million in 2025, which represents a staggering 24 percent increase from the prior year. Several of those executives saw their base salaries alone jump by more than $10 million in a single year – at the exact same moment that 40 percent of Americans reported going without the prescription drugs they need simply because they cannot afford them.

Let that sink in. Two out of five Americans skip medications over affordability. In Missouri, where working families already stretch every dollar, those numbers are not abstractions. They are neighbors, grandparents, and coworkers.

Critics of pharmaceutical accountability often argue that high drug prices fund research and development into tomorrow’s cures. It’s a compelling story. But it’s not what the numbers show.

When first-quarter 2026 earnings reports rolled in, the data revealed a pattern that should infuriate every Missouri taxpayer: major drugmakers are spending just as much on enriching shareholders through buybacks and dividends as they are on actual research and development. The R&D argument, Big Pharma’s long-standing primary political shield, is collapsing under the weight of its own quarterly disclosures.

In a political environment defined by division, pharmaceutical accountability has emerged as one of the few truly bipartisan issues left in American public life. New polling from the Pharmaceutical Reform Alliance shows that support for common-sense reforms crosses every partisan line. Support for Most Favored Nation drug pricing, requiring that Americans pay no more for medications than citizens of other wealthy countries, stands at 91 percent among Republicans, 70 percent among Independents, and 64 percent among Democrats.

This is the rare political moment where doing the right thing is the same as doing the popular thing. Missourians are watching to see who stands with Missouri families and who stands with Big Pharma.

Because Big Pharma sets the list price for every medication they sell, they are choosing to make those medications unaffordable for too many Americans. That is not a market failure; it is a deliberate corporate choice that demands a deliberate response.

Missouri households need Sen. Josh Hawley, Sen. Eric Schmitt and the entire Missouri congressional delegation to step up and stand with families rationing prescription drugs. The $157.8 million question isn’t about pharmaceutical CEO pay. It’s about whether Missouri representatives in Washington have the courage to answer it and deliver relief for Missourians’ already stretched household budgets.