You paid for the research. Then Medicare paid $16.14B for the drugs in 2025.

How this is built. A product is listed for one of two public records. Either NIH's Technology Transfer office lists it as an FDA-approved product built on a license from an NIH, CDC or FDA lab, or a patent the FDA lists for the drug was reported to NIH as an invention made with NIH grant money, as the Bayh-Dole Act requires. We then add what Medicare Part D, Part B and Medicaid paid for each product, and for each company, the federal grants and contracts it received, its PAC's donations and its lobbying.

What the numbers mean. Medicare and Medicaid figures are gross spending before the rebates drug makers pay back, which are confidential. Hospital-administered therapies such as CAR-T cell treatments are mostly paid under Medicare Part A and do not appear in these files. "NIH grants" is everything NIH paid on the grants a patent was reported under, from 1985 on; a grant usually paid for more than one invention, so it is not the cost of the drug. Federal contracts include purchases, such as vaccine doses, as well as research. Companies also paid for the clinical trials that took these products to approval. None of these figures shows that public money set a price or bought a decision.

Sources: NIH Technology Transfer: FDA-approved products licensed from NIH, CDC and FDA labs; NIH RePORTER patents reported under NIH grants (from iEdison); NIH RePORTER project funding; FDA Orange Book patent, exclusivity and product files; CMS Medicare Part D and Part B Spending by Drug (annual and quarterly); CMS Medicaid Spending by Drug; USAspending.gov federal grants and contracts. Updated 2026-11-06.