Bob Parant left his home on Long Island for the first time when he enrolled in college. Always interested in sports, he decided to try out for the football team in his sophomore year.

One day, Parant got a message to report to the athletic office.

“The coach calls me in and says, ‘You’ve got diabetes mellitus,’” Parant said. “That was back in 1972, and that’s where it started.”

Parant, now 73, has been living with diabetes for over 50 years.

He’s generally upbeat about his condition, despite the unending regimen of blood testing and insulin injections. None of that stopped him from having a successful career in pharmaceutical sales.

Yet one thing troubles Parant about needing this drug to stay alive. It’s the way drug makers seemingly game the system to keep prices high.

But opening the market to competition can be delayed by new patents, which can be created at any time for a particular drug, and can cover a variety of things.

“[Drug manufacturers] come out with another formulation of the drug, which gives them another number of years. And they just keep going, and generics and biosimilars cannot come into the market,” Parant said.

That tactic is known as a patent thicket.

The problem has been around since at least 2001, when Carl Shapiro of the University of California–Berkeley described it this way: “A patent thicket [is] a dense web of overlapping intellectual property rights that a company must hack its way through in order to actually commercialize new technology.”

Now, a group of bipartisan lawmakers is pushing for adoption of the ETHIC Act, which aims to eliminate the use of duplicative, overlapping patents. They say eliminating these patent thickets will increase competition in the prescription drug market, and that will lower prices for patients and taxpayers.

Patient advocates hail the legislation, though some analysts say there is no evidence that patents are being used to stifle innovation.

A pharmacy technician works in the P & P Pharmacy in Miami on Dec. 22, 2020. A group of bipartisan lawmakers is pushing for the adoption of the ETHIC Act, which aims to eliminate the use of duplicative, overlapping patents. Joe Raedle/Getty Images

How Thickets Work

The primary patent on a drug generally covers the active ingredient.

Beyond that, drug manufacturers often apply for patents to cover small changes in the product, such as a new coating, dosage, delivery method, or use to treat another disease.

They join the patents together with a legal device called a terminal disclaimer. This creates the “thicket.”

Then, when another company wants to release a cheaper version of the same drug, the company holding the patents can sue them in separate lawsuits claiming an infringement of each patent.

That makes it very expensive for a smaller company to challenge the dominance of a larger one.

Everybody Pays

Kris Garcia of Denver, Colorado, suffers from four bleeding disorders, asthma, and several allergies. The medications for each condition are expensive. One vial of a drug used to control bleeding costs $10,000—and four vials would be needed in an emergency.

The cost of that and other medications poses a constant threat to Garcia’s financial stability. “It changed the trajectory of my life,” Garcia said.

“I used to have a construction company. But I gave it up because it became impossible to provide my own health insurance. The prices were getting higher and higher.”

Like Parant, Garcia is frustrated by the tactics of pharmaceutical companies.

“They do all different kinds of maneuvers to extend their stronghold on these medications,” Garcia said. “It’s costing the patients. And it’s costing the taxpayers.”

Kris Garcia of Denver appears in this undated photo. Garcia suffers from four bleeding disorders, asthma, and several allergies, making medications very expensive. Courtesy of Kris Garcia

For some insured consumers, a drug may seem relatively inexpensive because they pay only a copayment or deductible. Even some cash-paying customers may pay a relatively low cost due to price caps or manufacturer assistance programs. The full cost is ultimately borne by employers and individuals paying insurance premiums, and by taxpayers.

Consumers with insurance may pay as little as $25 for Ozempic, the popular diabetes medicine that is sometimes prescribed off-label for weight loss.

Test of Reasonableness

When Don Kreis learned of a breakthrough treatment for cystic fibrosis, he was ecstatic. That was in 2019, when the FDA approved the drug Trikafta.

Vertex, maker of Trikafta, posted $12 billion in revenue for 2025, with net income of $4 billion, mostly derived from cystic fibrosis medications, according to a company statement.

That seems unreasonable to Kreis.

“I can’t continue to ask my neighbors, my fellow state employees, my fellow taxpayers in New Hampshire to fund those kinds of outrageously high expenses just to keep my family healthy,” Kreis said.

The Institute for Clinical and Economic Review, an independent research group, determined that a reasonable health-benefit benchmark price for Trikafta would be $67,900 to $85,500 per year.

Clearing the Thicket

Robert M. Davis, chairman and CEO of Merck, testified in 2024 that the company had invested $44 billion to develop its cancer drug Keytruda and will invest another $18 billion through the 2030s.

“Today’s investments drive tomorrow’s discoveries of breakthrough treatments,” Davis told the Senate Committee on Health, Education, Labor, and Pensions.

The bill was introduced by Rep. Jodey Arrington (R-Texas) in May 2025 and cosponsored by three other Republicans and five Democrats.

Hawley and Sens. Peter Welch (D-Vt.) and Amy Klobuchar (D-Minn.) introduced the bill in the Senate.

The ETHIC Act would allow drug companies to assert only one patent per patent group in a lawsuit, making it easier for competitors to hack through the thicket and introduce generic drugs.

More than two dozen advocacy and research groups, joined by a nearly equal number of scholars and lawyers, urged Congress to take action on the bill.

Others see it as a misguided attempt to solve the problem of drug pricing.

Rose Kreis receives treatment for cystic fibrosis, in this undated photo. Courtesy of Don Kreis

“The bill advances a misleading narrative about so-called patent thickets,” the Council for Innovation Promotion said in a statement. The group describes itself as “a bipartisan coalition dedicated to promoting strong and effective intellectual property rights.”

It added that a complex product can require multiple patents to adequately protect its components.

The Patent and Trademark Office in 2024 concluded that simply counting the patents on a product is an imprecise way to measure their value because each could have a different scope.