3 Axis Advisors is a for-profit consulting firm in Ohio that publishes reports on drug-pricing issues. The reports are critical of the extent to which drug companies, pharmacies, and other intermediaries profit from pharmaceutical medicines. ^{1 2}

In February 2025, the Washington Examiner published a report claiming that 3 Axis Advisors is substantially funded by pharmaceutical companies. In 2023, 3 Axis Advisors partnered with America’s Agenda Healthcare Education Fund (America’s Agenda) to provide research; in 2008, America’s Agenda received $1 million in funding from Pharmaceutical Research and Manufacturers of America (PhRMA), a trade organization representing pharmaceutical companies. America’s Agenda’s board members are also executives from pharmaceutical companies, one of whom is PhRMA Senior Vice President Scott LaGanga. Additionally, the Washington Examiner reports that PhRMA and America’s Agenda campaign in opposition to pharmacy benefit managers, which is a primary focus of 3 Axis Advisors’ and 46brooklyn Research’s research. ³

3 Axis Advisors advocates that policymakers limit drug manufacturers from being able to receive patent protection for modifying existing drugs and implement price controls on generic drugs, as 3 Axis argues individuals are unable to assess the fairness of market drug prices. ²

Background

3 Axis Advisors is a for-profit consulting firm that was founded in 2019 and researches pharmacy data to analyze drug pricing issues. It also reports using its research to support its sister organization 46brooklyn Research’s advocacy. ^{4 5} 46brooklyn Research uses data associated with drug pricing to scrutinize drug company profit margins and associate it with inflation.  ⁶

3 Axis Advisors publishes research reports that focus on the role of pharmacy benefit managers, drug reimbursement, plan sponsors, and regulations in affecting drug pricing. It advocates that policymakers regulate drug pricing throughout the supply chain because it is too complex for market participants to use competition to lower drug prices. ¹

Reports

In January 2025, 3 Axis Advisors published a report on Medicare’s Maximum Fair Price drug price negotiation program that was created by the Biden administration-backed Inflation Reduction Act. The report argued that the program will result in reduced profitability and increased losses for pharmacies, criticizing it for potentially impacting profitability and for delaying drug manufacturer refund payments. ⁷ It criticized the program for affecting the cash flow of pharmacies due to the delay and argued that by reducing profitability, innovation and research into new drugs could be disincentivized. ¹

In June 2024, 3 Axis Advisors published a report that analyzed over nine million prescription drug claims in the state of Washington between 2020 and 2023 to analyze why pharmacy benefit managers charge different prices on the same drug for patients and plan sponsors, and different reimbursement rates provided to the pharmacy. It argues that due to the various influences on drug pricing, it is too complicated to address drug price issues because of the “competing incentives” of the different market participants. The report concluded that pharmacies, drug companies, and insurance companies needed to be more transparent to allow for market competition to create lower drug prices. ⁸

In September 2023, 3 Axis Advisors published a report on how to address high prescription drug pricing, attempting to determine the cause of high costs. It argues that, in part, drug manufacturers are setting high prices but that pharmacy benefit managers control the cost of drug prices, largely at their discretion. The report claims that there are indescribable differences in drug pricing that pharmacy benefit managers assess to patients and that the prices assessed are influenced by the rate at which insurance providers and the government reimburse drug costs. It concludes by arguing that regulating drug prices is the only way to address the issue. ⁹

Leadership

Antonio Ciaccia is the president of 3 Axis Advisors and CEO of 46brooklyn Research. He began his career as a pharmacy technician and later became head of government affairs for the Ohio Pharmacists Association. ¹⁰

1. “Projects.” 3 Axis Advisors. Accessed February 23, 2025. https://www.3axisadvisors.com/projects.
2. Ciaccia, Antonio. “Uncovering U.S. Drug Pricing Distortions.” Pennsylvania General Assembly, 2024. https://www.legis.state.pa.us/WU01/LI/TR/Transcripts/2020_0024_0001_TSTMNY.pdf.
3. Schmad, Robert. “News outlets circulated drug research from nonprofit group without disclosing its pharmaceutical industry ties.” February 12, 2025. https://www.washingtonexaminer.com/news/investigations/3317274/drug-research-nonprofit-pharmaceutical-industry-ties/.
4. “About.” 3 Axis Advisors. Accessed February 23, 2025. https://www.3axisadvisors.com/about.
5. “3 Axis Advisors.” LinkedIn. Accessed February 23, 2025. https://www.linkedin.com/company/3axisadvisorsconsultancy/about/.
6. Home. 46brooklyn Research. Accessed February 23, 205. https://www.46brooklyn.com/.
7. “Unpacking the Financial Impacts of Medicare Drug Price Negotiation: Analysis on Pharmacy Cash Flows.” 3 Axis Advisors. January 30, 2025. https://www.3axisadvisors.com/projects/2025/1/30/unpacking-the-financial-impacts-of-medicare-drug-price-negotiation-analysis-on-pharmacy-cash-flows.
8. “Understanding Drug Pricing from Divergent Perspectives: State of Washington Prescription Drug Pricing Analysis.” 3 Axis Advisors. June 24, 2024. https://www.3axisadvisors.com/projects/2024/6/25/understanding-drug-pricing-from-divergent-perspectives-state-of-washington-prescription-drug-pricing-analysis-jh92
9. “Unravelling the Drug Pricing Blame Game.” 3 Axis Advisors. September 19, 2023. https://www.3axisadvisors.com/projects/2023/9/19/unravelling-the-drug-pricing-blame-game.
10. “Team.” 3 Axis Advisors. Accessed February 23, 2025. https://www.3axisadvisors.com/team.