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Partnership to Fight Infectious Disease is a group of patients, providers, community organizations, business and labor groups, and health policy experts working to advance awareness and action on antimicrobial resistance. PFCD in the States As lawmakers continuously review changes to our health care system, it is incumbent upon leaders on both sides of the aisle to acknowledge the single largest driver of health care spending – chronic disease – and present a concrete plan for addressing this human and economic threat. Ninety cents of every health care dollar spent is spent on treating people with chronic disease. Chronic diseases are the leading causes of death and disability. One in two Americans lives with at least one chronic condition and almost three in four older Americans have one or more than one chronic condition. The good news is that most chronic diseases are preventable or manageable. With a health care system that better detects, treats, and manages chronic disease, we can change our nation’s health care story, improve the lives of millions of Americans, and strengthen our economy by tackling chronic disease. Join us in the #Fight4Health and demand leadership on the issue from all our policymakers. PFCD worked with GlobalData on a microsimulation analysis to assess chronic disease trends in the U.S. and across the states. The fact sheet data highlights averages of annual outcomes from 2015-2030. For more information about the study and methodology, read the FAQs. U.S. Chronic Disease Fact Sheet U.S. Chronic Disease Fact Sheet

The Partnership to Fight Chronic Disease (PFCD) is an internationally-recognized organization of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs: chronic disease Chronic Disease Patients Prioritized in Trump Administration Executive Order Since 2007, the Partnership to Fight Chronic Disease (PFCD) has been an internationally-recognized organization of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs: chronic disease. The Problem: Preventable and Mismanaged Chronic Disease Chronic diseases, such as diabetes, COPD, cancer, depression, obesity and heart disease, are the leading causes of death and disability in the United States and account for the vast majority of health care spending. More than one in two American adults lives with at least one chronic condition and nearly one in three liv e with two or more chronic conditions. Chronic diseases are also the primary driver of health care costs—accounting for 90 cents of every dollar we spend on health care in this country. In 2011, this amounted to $2.3 trillion of the $2.7 trillion spent on health care. Despite these widespread problems, the issue of chronic disease does not register with large segments of the public and policymakers as an issue of primary concern. The Solution: A National Partnership Aimed at Fighting Chronic Disease As the CDC has said, “The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases.” Added to that, the World Health Organization estimates that as much as 80 percent of premature heart disease, stroke, and type 2 diabetes, and 40 percent of cancers could be avoided entirely if Americans avoided tobacco, developed healthier eating habits, and were more physically active . That’s why a broad group of patient, provider, community, business and labor groups, and health policy experts, joined together to form the Partnership to Fight Chronic Disease (PFCD)—a coalition committed to raising awareness of the rising rates of preventable and treatable chronic diseases. Our Mission: Rising rates of chronic diseases pose an unsustainable burden on our health care system. The viability and strength of the system—now and in the future—rely on a willingness to enact policies that help Americans better prevent and manage chronic illnesses. As a result, the mission of the PFCD is to: Drive awareness of burden of chronic disease and solutions at work shown to improve health for individuals and communities Empower change in how we prevent and treat chronic disease in America to enhance health Challenge decision-makers to adopt policy changes necessary to prevent and lessen burden of chronic disease

The Partnership to Fight Chronic Disease (PFCD) is an internationally-recognized organization of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs: chronic disease Resources RESOURCES > DEFINING "UNMET MEDICAL NEED" Defining "Unmet Medical Need" Patients, people with disabilities, and their caregivers want their experiences and outcomes that matter to them to be considered when the government or other payers make decisions about their treatments. The Inflation Reduction Act (IRA) directs the U.S. Federal government to establish the price for some of the highest selling drugs in the Medicare program based on a number of factors including whether the drug serves an “unmet medical need” relative to other therapeutic options. This report highlights the perspectives of the patient community on “unmet medical needs” based on survey research and public comments from patient advocacy groups and compares those findings to the government’s proposed approach to consider unmet medical needs under the IRA. WHITE PAPER Defining "Unmet Medical Need" in the Inflation Reduction Act for the Maximum Fair Price Reflecting Patient Input

December 5, 2025 (WASHINGTON, D.C.)  The Partnership to Fight Chronic Disease (PFCD) released the following statement in response to the introduction of the Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act:   “The Partnership to Fight Chronic Disease (PFCD) applauds Senate Finance Committee Chairman Mike Crapo and Ranking Member Ron Wyden for introducing the bipartisan Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act , which aims to fix market distortions and lower prescription drug costs for patients and taxpayers. For the more than 190 million Americans living with one or more chronic conditions, reforms that increase transparency, fairness, and accountability among PBMs are essential to improving access and affordability.   “Efforts to make America healthier require policymakers to address misaligned incentives that allow PBMs to profit while patients face rising premiums, deductibles, and coinsurance at the pharmacy counter. By delinking PBM compensation from list prices and requiring that Medicaid payments flow more directly to pharmacies and dispensing providers, this legislation moves the system closer to one that prioritizes patients over middlemen.   “This legislation’s provisions to strengthen reporting, audit authority, and ‘any willing pharmacy’ contracting will help safeguard independent and rural pharmacies that many people with chronic conditions rely on for timely access to medicines and counseling. These steps, combined with greater oversight of PBM practices across Medicare and Medicaid, reflect the kind of bipartisan, patient-centered solutions PFCD has consistently championed to protect access while addressing affordability.   “Achieving better health outcomes requires a comprehensive approach that pairs prevention with reliable access to evidence-based treatments. Greater transparency when it comes to cost and access for prescribed treatments is essential for people living with chronic conditions and the providers supporting their care. This bill is an important step in that direction, and PFCD urges Congress to swiftly advance this legislation.”

More than half of American adults manage multiple chronic conditions . The prevalence is enough to strain the U.S. healthcare system and challenge patient access to new treatments. To compound the issue, pharmacy benefit managers (PBMs) and others siphon nearly half of every dollar spent on brand-name drugs, driving up costs for patients. Reform for how Americans access drugs is a primary topic in Washington. Of the two trending options on the table, only one puts patients first. PBM reform and most favored nation (MFN) pricing have gained significant recent traction. One key distinction is the former directly confronts the issue at hand by mitigating the influence of middlemen, whereas MFN imports drug prices set by foreign governments with a riskier range of potential outcomes. Any solution must prioritize patient access. Today, PBMs wield enormous influence over which medicines patients receive and what they pay. Their rebate-driven models, formulary barriers, and use of affiliated group purchasing organizations (GPOs) often prioritize financial return over clinical need. For people managing chronic disease, these practices can delay effective therapy and inflate out-of-pocket costs. PBM reform seeks to restore patient-centered access by curbing opaque pricing practices and ensuring negotiated savings reach patients. By reducing pricing distortions created by PBMs and increasing transparency, reform targets the systemic barriers that most consistently raise costs for patients. In the interim, direct-to-patient (DTP) programs can offer short-term relief. They allow patients to bypass intermediaries altogether and buy medications directly from manufacturers at a transparent, often significantly discounted, price. For some, especially those with high deductibles, limited coverage or no insurance, DTP would address unpredictability at the pharmacy counter and minimize surprise costs. In time, there could be an opportunity to expand DTP, integrating insurance coverage and enabling broader participation. MFN moves the U.S. in another direction. By tying drug prices to those set in foreign markets, MFN would introduce volatility that would limit patient access to new medicines. By undermining the conditions that support steady development, testing, and rollout of new therapies, MFN would jeopardize access for patients who rely on new therapies to manage complex or rare conditions. The pursuit of parity with other nations can come at the expense of timely care for Americans who need it most. Across Europe and Canada, patients routinely face delayed and constrained access to medicines due to government price-setting practices. In Canada, a 2021 Fraser Institute analysis found newly approved therapies often arrive over a year later  than their U.S. equivalents, shrinking treatment windows for people with chronic disease. In the U.K., rare disease patients are frequently denied access  to transformative treatments when the National Institute for Health and Care Excellence deems them not to be “cost-effective”. It would be precarious to address affordability in the U.S. by treating countries with major access concerns as the rubric. It’s also clear from those experiences that we cannot simply adopt foreign prices and still enjoy U.S.-level access to medicines or have the same pace of innovation. PBM reform provides a clearer path forward. While no single solution can fully address the challenges that Americans with chronic disease face, any solution should strengthen the connection between patients and their prescribed therapies, ensuring affordability and consistent access.

Becoming a new mother is often described as one of life’s most extraordinary experiences. Yet for many women, the period following childbirth is also marked by profound physical, emotional, and systemic challenges. As chronic diseases become increasingly common contributors to maternal complications and mortality, understanding and addressing the broader social determinants of health is essential to addressing the realities, especially those facing Black mothers and their babies. Black women and mothers face a disproportionately high risk for a range of cardiovascular conditions. According to the American Heart Association , Black women experience higher rates of hypertension, heart failure, peripartum cardiomyopathy, and stroke, often beginning earlier in life and progressing more aggressively than in other groups. Added elements like chronic stress, limited access to preventive care, and inadequate postpartum follow-up intensify these risks during pregnancy and motherhood. The Partnership to Fight Chronic Disease continues to shine a light on the disproportionate impact of chronic disease on maternal health outcomes. On December 3 rd , PFCD joins California State Senator Dr. Akilah Weber Pierson for another follow up event focused on supporting the health and wellness of Black mothers. This gathering will bring together clinicians, community leaders, researchers, and advocates to discuss how chronic disease management and equitable care access can transform maternal and infant outcomes. A Crisis Rooted in Inequity Black women in California are more than four times more likely  to die from pregnancy-related causes than white women. Nationwide, they are nearly three times more likely  to experience maternal mortality. These disparities cannot be separated from the chronic diseases that disproportionately affect Black women—conditions that often go undiagnosed, undertreated, or unsupported before, during, and after pregnancy. Black women are: 60% more likely  to have high blood pressure At significantly higher risk for diabetes and heart disease More likely to develop gestational diabetes , increasing future risk of Type 2 diabetes More likely to experience worsening hypertension postpartum , raising long-term heart disease risks These chronic conditions can complicate pregnancy, delivery, and recovery, yet the barriers Black women face in accessing consistent, culturally competent care often make managing these problems deeply challenging. Health outcomes are shaped by far mor e than biology. For Black mothers, the following factors play an outsized role in health outcomes : Limited access to high-quality healthcare Insurance gaps Financial stress Under-resourced neighborhoods Lack of culturally competent providers Distance from health facilities Collectively, these systemic inequities not only make it harder to receive timely and appropriate care but more broadly create an environment where Black women must not only adapt to life with a newborn but simultaneously navigate chronic conditions without the level of support they need and deserve. Chronic Disease: A Driving Force Behind Maternal Mortality The connection between chronic disease and maternal health outcomes is stark. From 2020 to 2021 alone, the U.S. maternal mortality rate rose by more than one-third. The rate for Black mothers was more than twice that for white mothers. Even before the pandemic, chronic diseases accounted for half of all maternal deaths  in the United States. They remain the fastest-rising cause of maternal mortality today. In San Diego County, Black infants are nearly three times more likely  to die during their first year of life and are 60% more likely  to be born premature—further demonstrating how chronic disease, inequity, and maternal health intertwine. Sickle cell disease, which disproportionately affects Black women, carries its own heightened risks and women with sickle cell are more likely to deliver younger, live in under-resourced communities, and experience stillbirth. PFCD remains committed to raising awareness, advocating for systemic change, and pushing for policies that eliminate racial discrimination in healthcare and address the social determinants that produce harmful disparities. To meaningfully reduce disparities and improve outcomes, we must: 1. Invest in culturally competent and accessible care. 2. Strengthen chronic disease prevention and management. From early screening to long-term management, prioritizing heart health, diabetes prevention, blood pressure control, and sickle cell care is essential. 3. Expand access to mental health services. Support must be affordable, stigma-free, and rooted in community understanding. 4. Address social determinants of health. Transportation, childcare, housing stability, nutrition, and economic security directly shape maternal well-being. 5. Drive policy based on equity and evidence. ALL mothers deserve not only survival but the opportunity to thrive. By prioritizing maternal health, addressing chronic disease, and confronting the systemic barriers that shape outcomes, we can build a future where every mother has the care, support, and dignity she deserves.