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Carlos Delgado / AP

Pharmaceutical companies and pharmacy benefit managers are pointing fingers at each other to explain why patients are spending more out of their own wallets for their prescription drugs. The latest battle revolves around the list prices of drugs.

PhRMA's jab: A report Wednesday from the main drug industry lobbying group, Pharmaceutical Research and Manufacturers of America, said half of out-of-pocket spending by people with commercial health insurance on brand-name prescription drugs comes from deductibles and coinsurance. Those are based on the drug's higher list price and do not factor in negotiated rebates. The health plans and pharmacy benefit managers "do not share these discounts with patients who pay a deductible or coinsurance," PhRMA said.

The counterpunch: The Pharmaceutical Care Management Association, which represents pharmacy benefit managers, quickly defended itself by saying the "simplest, most obvious way for drugmakers to reduce costs and improve access is to cut their prices."

Between the lines: Both sides raise valid concerns. Drug companies ultimately decide the prices of their products, and if they want patient cost-sharing to be lower, it would come at the expense of higher premiums. However, the middlemen are demanding bigger rebates in exchange for putting drugs on their formularies, which encourages drug companies to keep prices high to give bigger rebates. It's a vicious cycle on both ends of a profitable system.

Go deeper

15 mins ago - Politics & Policy

Sarah Huckabee Sanders to run for governor of Arkansas

Sarah Huckabee Sanders at FOX News' studios in New York City in 2019. Photo: Steven Ferdman/Getty Images

Former White House press secretary Sarah Huckabee Sanders will announce Monday that she's running for governor of Arkansas.

The big picture: Sanders was touted as a contender after it was announced she was leaving the Trump administration in June 2019. Then-President Trump tweeted he hoped she would run for governor, adding "she would be fantastic." Sanders is "seen as leader in the polls" in the Republican state, notes the Washington Post's Josh Dawsey, who first reported the news.

Updated 32 mins ago - World

Mexican President López Obrador tests positive for coronavirus

Mexico's President Andrés Manuel López Obrador during a press conference at National Palace in Mexico City, Mexico, on Wednesday. Photo: Ismael Rosas/Eyepix Group/Barcroft Media via Getty Images

Mexican President Andrés Manuel López Obrador announced Sunday evening that he's tested positive for COVID-19.

Driving the news: López Obrador tweeted that he has mild symptoms and is receiving medical treatment. "As always, I am optimistic," he added. "We will all move forward."

Coronavirus has inflamed global inequality

Illustration: Aïda Amer/Axios

History will likely remember the pandemic as the "first time since records began that inequality rose in virtually every country on earth at the same time." That's the verdict from Oxfam's inequality report covering the year 2020 — a terrible year that hit the poorest, hardest across the planet.

Why it matters: The world's poorest were already in a race against time, facing down an existential risk in the form of global climate change. The coronavirus pandemic could set global poverty reduction back as much as a full decade, according to the World Bank.

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