Recent comments by Australian negotiators indicate that the US is seeking changes to Australia's intellectual property laws, particularly as they relate to pharmaceuticals. Such changes have the capacity to undermine the effectiveness of the pharmaceutical benefits scheme and lead to higher costs in Australia. Buddhima Lokuge, Thomas Alured Faunce and Richard Denniss analyse the likely impact of such changes and concludes that the cost to Australian taxpayers is likely to be in excess of $1 billion over four years.