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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

The social media addiction bubble

Illustration: Annelise Capossela/Axios

Right now, everyone from Senate leaders to the makers of Netflix's popular "Social Dilemma" is promoting the idea that Facebook is addictive.

Yes, but: Human beings have raised fears about the addictive nature of every new media technology since the 18th century brought us the novel, yet the species has always seemed to recover its balance once the initial infatuation wears off.

Young people's next big COVID test

Illustration: Eniola Odetunde/Axios

Young, healthy people will be at the back of the line for coronavirus vaccines, and they'll have to maintain their sense of urgency as they wait their turn — otherwise, vaccinations won't be as effective in bringing the pandemic to a close.

The big picture: "It’s great young people are anticipating the vaccine," said Jewel Mullen, associate dean for health equity at the University of Texas. But the prospect of that enthusiasm waning is "a cause for concern," she said.

7 hours ago - World

New Zealand authorities charge 13 parties over deadly volcano eruption

Prime Minister Jacinda Ardern at New Zealand's parliament in Wellington. Photo: Mark Tantrum Photography via Getty Images

New Zealand authorities laid safety violation charges Monday against 10 organizations and three individuals over the fatal Whakaari/White Island volcanic disaster last December, per a statement from the agency WorksSafe.

Details: WorksSafe declined to name those charged as they may seek name suppression in court. But Prime Minister Jacinda Ardern said government agencies GNS Science, which monitors volcanic activity, and the National Emergency Management Agency were among those charged over the "horrific tragedy" that killed 22 people.