Why It Matters

Biopharmaceutical company Ardelyx Inc. has added another lobbying firm to its already extensive roster. The company retained McManus Group for $60,000 to focus on Medicare and Medicaid reimbursement issues. This marks Ardelyx’s tenth lobbying firm since 2018, reflecting the company’s aggressive advocacy strategy on kidney disease policy.

By the Numbers

Ardelyx has spent heavily on lobbying since 2018:

  • Total external lobbying: $3.75 million across nine firms
  • Internal lobbying: $6.72 million through in-house operations
  • McManus Group: $80,000 total across three 2025 disclosures
  • Top firm: Roberti Global LLC at $1.02 million

The McManus Group team includes founder John E. McManus, who previously served as Staff Director for the House Ways and Means Health Subcommittee.

Broader Context

Congress is actively considering multiple bills affecting kidney disease treatment. The Restore Protections for Dialysis Patients Act aims to prevent private insurers from discriminating against dialysis patients. The Dialysis-Related Amyloidosis Treatment Act would create separate Medicare reimbursement outside bundled payments. Bipartisan support has emerged, with lawmakers from both parties introducing kidney-related legislation.

The Agenda

Ardelyx is lobbying specifically on the 2025 End-Stage Renal Disease Prospective Payment System Final Rule. The company opposes including oral-only drugs in bundled payments. This mirrors their historical focus on the Kidney PATIENT Act, which seeks to delay oral drug inclusion in bundled payment systems.

Competitive Landscape

Ardelyx faces crowded competition in kidney disease lobbying. Pharmaceutical companies Akebia Therapeutics and Vifor International AG lobby on similar issues. Dialysis providers DaVita Inc. and Fresenius Medical Care maintain extensive operations. Industry groups like Kidney Care Partners and American Kidney Fund also advocate actively.

Between The Lines

Congressional activity has intensified around kidney issues. Representatives Carol Miller and Suzan DelBene re-launched the bipartisan Congressional Kidney Caucus. Senator Kirsten Gillibrand introduced the SMART Prices Act to expand Medicare drug price negotiation. Senator Thom Tillis introduced the EPIC Act addressing research disincentives. No recent hearings have focused specifically on oral drug reimbursement.

The Bottom Line

Ardelyx’s hiring of McManus Group represents continued investment in specialized Medicare expertise.

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