Apr 9, 2019

All eyes are on the drug pricing middlemen

Illustration: Sarah Grillo/Axios

Pharmacy benefit managers usually operate behind the scenes, quietly influencing the 5.8 billion drug prescriptions Americans fill every year. But they'll take a step into the spotlight today.

Driving the news: The Senate Finance Committee is set to grill the industry over its role in rising drug prices, and at the same time, the Trump administration is weighing a seismic shift in how these companies get paid.

Between the lines: PBMs don't have many enthusiastic allies.

The biggest threat for PBMs is the Trump administration's proposal to eliminate drug rebates in Medicare and Medicaid, instead routing those savings to patients at the pharmacy counter.

What they're saying: Independent experts are giving sober forecasts for the proposal. It wouldn't be a drug pricing panacea, they say, and it could make everything more expensive.

The bottom line: PBMs are getting hammered. The next few months will dictate how their businesses — and patients' costs — will change, and how much of that change will happen before the 2020 election.

Go deeper

America's small business bailout is off to a bad start

Illustration: Sarah Grillo/Axios

Websites have crashed, phones are jammed and confusion reigns as businesses rushed at today's kickoff to get their chunk of the $350 billion Paycheck Protection Program.

Why it matters: This is a race to save jobs in the present and the future, and to ensure that as many workers as possible keep their benefits and paychecks during the coronavirus lockdown.

Go deeperArrow27 mins ago - Health

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 p.m. ET: 1,076,017 — Total deaths: 58,004 — Total recoveries: 225,335Map.
  2. U.S.: Total confirmed cases as of 3 p.m. ET: 261,438 — Total deaths: 6,699 — Total recoveries: 9,428Map.
  3. Business latest: Mark Cuban criticizes "arrogant" 3M on respirator production — The wartime mobilization effort to produce ventilators and medical supplies got started too late.
  4. Oil latest: The amount of gasoline American drivers are consuming dropped to levels not seen in more than 25 years, government data shows.
  5. Politics latest: Lawmakers on both sides of the aisle are worried about the difficulties of delivering the $2.2 trillion in stimulus aid.
  6. Jobs update: The U.S. lost 701,000 jobs in March, but the new report doesn't reflect the height of the virus' impact on the economy.
  7. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  8. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

Coronavirus fuels historic drop in gasoline demand

Reproduced from EIA; Chart: Axios Visuals

The amount of gasoline American drivers are consuming dropped to levels not seen in more than 25 years, government data shows.

Driving the news: When most of us are staying home and not driving, this is one of the most predictable—but nonetheless still staggering—upshots of the unfolding coronavirus crisis.