There are practical, politically plausible reforms that would reduce undue industry influence while still allowing pharmaceutical companies to participate constructively in policymaking.

The goal is to move from informal, money-driven access to rules-based, transparent engagement that preserves technical input but limits capture.

Below I unpack a set of reforms (legal, institutional, and procedural), explain why each matters, and show how industry can still have a legitimate voice through safer channels.

1) Strengthen transparency so influence is visible and auditable

Require real-time, machine-readable disclosures for lobbying, campaign contributions, and third-party spending tied to health policy. Expand the scope of the Sunshine/Open Payments reporting to include payments to patient groups, think tanks, and professional societies that lobby or testify on health policy. Transparency doesn’t stop capture by itself, but it sharply raises political costs for covert influence and enables journalists, researchers, and watchdogs to trace patterns. Empirical reviews show disclosure is necessary but not sufficient — it’s a foundation for accountability. 

How pharma still gets a voice: mandatory disclosure simply makes conversations public; companies can continue to fund research and advocacy but must do so openly, allowing counter-voices and contextual analysis.

2) Extend and enforce meaningful “cooling-off” periods (revolving-door limits)

Current federal cooling-off windows (typically one to two years for certain contacts) are short and narrow. Extending cooling-off periods to 3–5 years for senior regulators, heads of agencies, committee chairs, and key staff would reduce the immediate financial incentive to curry favor and blunt the most blatant forms of regulatory capture. CRS and advocacy analyses show longer bans reduce the appearance and risk of conflicts. 

How pharma still gets a voice: firms can employ former officials for long-term advisory or operational roles after the cooling period, and can rely on their internal R&D and regulatory affairs teams to engage publicly in policymaking.

3) Reform FDA funding to reduce dependency on industry user fees

The FDA funds a large part of its drug-review budget from user fees (PDUFA/GDUFA). That creates perceived and real conflicts because regulated firms finance the regulator’s operations. Incrementally shifting funding toward stable federal appropriations, or at least tightening negotiation transparency and performance metrics around PDUFA, would strengthen independence. Academic reviews of PDUFA show the tradeoffs between speed and regulatory priorities; reform debates emphasize funding diversification. 

How pharma still gets a voice: user fees can be retained for performance commitments but accompanied by strict public reporting, independent oversight panels, and prohibition on fee-dependent staffing decisions that align FDA priorities with industry timelines.

4) Condition public R&D funding on access and licensing safeguards

When taxpayers fund basic research or subsidize manufacturing (grants, advance purchase agreements), attach contractual conditionalities: mandatory licensing on reasonable terms, time-limited exclusivity, or required technology transfer in emergencies. Economic and policy literature supports conditionality as a tool to align public investment with public benefit. 

How pharma still gets a voice: conditionalities would be calibrated (reasonable royalties, stepwise transfer) so firms are compensated and remain motivated to commercialize, while ensuring governments can secure access when public funds underpin development.

5) Tighten limits on direct political spending; bolster public & small-donor financing

Restrict corporate political contributions at the federal level (or at least limit corporate PAC coordination) and expand public financing or matching funds for candidates so politicians are less reliant on big donors. This reduces the transactional power of industry money. Evidence shows that public financing and small-donor amplification change incentives for access and responsiveness. 

How pharma still gets a voice: companies can participate through registered, transparent lobbying and formal consultations rather than electoral finance; industry trade associations can still make public policy submissions.

6) Upgrade conflict-of-interest rules for advisory bodies and panels

Mandate stricter conflict-of-interest screening for any advisory committee (FDA advisory panels, HHS task forces) with clear thresholds for allowable financial ties, mandatory recusal, and public rationales for exceptions. Research suggests disclosure alone is inadequate — stronger exclusion rules are sometimes necessary to preserve credibility. 

How pharma still gets a voice: require that panels include balanced representation (independent experts, patient advocates, academic scientists) and allow industry to offer technical briefings but not dominate deliberations or votes.

7) Regulate third-party influence: disclose and audit funded advocacy

Require registration and periodic audits for organizations that engage in targeted lobbying or run issue-advertising funded above a threshold (e.g., >$100k/year from a single industry source). This would expose astroturf campaigns and show when patient-group advocacy is materially industry-backed. Evidence flags this as a major channel of indirect influence. 

How pharma still gets a voice: companies can fund community outreach and disease awareness, provided funding sources and messaging are transparent and labeled.

8) Strengthen antitrust enforcement and speed up pay-for-delay / PBM scrutiny

Robust antitrust action against anti-competitive tactics (pay-for-delay, sham patent litigation, vertical consolidation) reduces market-power strategies that make lobbying more valuable. Agencies should prioritize fast investigations and civil remedies where conduct raises prices or blocks entry. Enforcement pressure changes the calculus of lobbying returns. 

How pharma still gets a voice: firms with legitimate competitive products remain free to advocate for sensible IP protections and to participate in rulemaking.

9) Create formal, rule-bound public-private advisory mechanisms

Set up transparent co-design forums where industry technical experts, government scientists, and civil-society representatives work under published rules (timelines, disclosure, published minutes) to solve technical problems — manufacturing scale-up, supply chain resilience, or clinical-trial design. By institutionalizing the channel, you keep expert input while reducing backroom influence. Policy practice and governance literature support structured engagement over ad-hoc access. 

Conclusion — calibrating influence, not silencing it

These reforms are complementary: transparency + longer cooling-offs + funding reform + conditional public investment + stronger COI rules + antitrust enforcement + structured advisory channels would greatly reduce undue capture while preserving legitimate, structured industry input. The aim is not to shut companies out — they supply essential expertise and capacity — but to shift influence from opaque, cash-driven pathways to open, rules-based processes where policymakers, patients, and independent science share the table and outcomes can be audited.

If you’d like, I can convert this into a policy brief with proposed legislative text snippets (e.g., a model cooling-off statute, PDUFA funding transition timetable, or a contract clause for public R&D conditionality) you could use for advocacy or reporting.