46brooklyn Research is a nonprofit organization that publishes research on pharmaceutical data and uses it to argue that pharmacy benefit managers are responsible for high drug costs. ¹ It is also critical of pharmacies, wholesalers, and manufacturers for their profits from generic drugs. ²

46brooklyn Research’s board of directors includes individuals who have ties to the pharmaceutical industry, including Hock’s Pharmacy Jeffrey Bartone, SharpRx Pharmaceutical Consultation Services president Michael Sharp, and McGohan Brabender CEO Scott McGohan. ³

Background

46brooklyn Research is a nonprofit research organization that was founded in 2018 to review drug pricing data that is used to advocate for drug pricing issues. It is the sister organization of 3 Axis Advisors, which consults with organizations on drug pricing issues. ²

In February 2025, the Washington Examiner published a report that claimed 46brooklyn Research is substantially funded by pharmaceutical companies through payments made to its sister organization, 3 Axis Advisors. It claimed that in 2023, 3 Axis Advisors partnered with the America’s Agenda Healthcare Education Fund (America’s Agenda) to provide research and that 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. Additionally, the Washington Examiner reported 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. ⁴

Reports

In 2020, 46brooklyn Research submitted a report to the Pennsylvania General Assembly discussing the influences of drug pricing differences for patients and the amounts paid to drug companies from plan providers. The report criticized drug companies for modifying old versions of drugs to reset the patent protection period and extend the time until manufacturers can create a generic alternative at a competitive price. It also criticizes pharmacies and suppliers for marking up drug prices and drug companies for providing pharmacy benefit managers with incentives to provide patients with more expensive drugs. To address these issues, the report advocated regulations that would implement price controls. ²

In April 2022, 46brooklyn Research published a report analyzing Medicare’s drug spending. The report used data from its Medicare Part D Drug Pricing Dashboard based on data from Medicare’s annual Medicare Trustees report and scrutinized spending on specialty drugs, arguing that Medicare is overpaying for specialty and brand name drugs. It concluded that Medicare-contracted pharmacy benefit managers were excessively reimbursing drug companies for specialty drugs while arguing they create an illusion that drug companies are choosing to overcharge Medicare. ⁵

In May 2023, 46brooklyn published a report titled, “How PBMs Distort and Undermine Specialty Drug Pricing Guarantees.” The report argued that drug pricing is “irrational” as the varying contracts between health plans and drug companies along with the definitions used in the contracts are convoluted and superfluous, causing the cost negotiation process to be inefficient. It specifically placed blame on pharmacy benefit managers, or PBMs, for taking advantage of the confusing contracts by allowing pharmacies to overcharge patients for medicines and over-reimburse drug companies for specialty drugs. ¹

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. ⁶

1. “How PBMs distort and undermine specialty drug pricing guarantees.” 46brooklyn Research. May 10, 2023. https://www.46brooklyn.com/research/2023/5/10/how-pbms-distort-and-undermine-specialty-drug-pricing-guarantees-blac.
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. “Board of Directors.” 46brooklyn Research. Accessed February 24, 2025. https://www.46brooklyn.com/board-of-directors.
4. ^[1] 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/.
5. “Medicare hits $200 billion in gross drug spend: Who gets the blame?” 46brooklyn Research. April 11, 2022. https://www.46brooklyn.com/research/2022/4/11/medicare-hits-200-billion-in-gross-drug-spend-janx38.
6. “Team.” 3 Axis Advisors. Accessed February 23, 2025. https://www.3axisadvisors.com/team.