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Photo: Julia Rendleman/Getty Images for Eventive Marketing

If Express Scripts is any kind of bellwether for drug rebates — pricing discounts that drug manufacturers pay to pharmacy benefit managers so their drugs get put on the drug coverage lists — then those dollars continue to rise.

By the numbers: Cigna, which bought Express Scripts last year, said it is owed almost $4 billion in rebates from pharmaceutical companies as of Sept. 30, according to new investor documents. That's up almost $600 million since the start of this year.

  • UnitedHealth Group, which owns OptumRx, counted $4.2 billion worth of drug rebate "receivables" as of Dec. 31, 2018, but hasn't provided updates since then. CVS and Humana similarly control billions of dollars in rebates.

Between the lines: Pharmacy benefit managers, or PBMs, don't keep all of those dollars. A lot goes back to large employers, governments and health plans as a way to lower premiums.

  • But even the small percentage that is retained results in hundreds of millions of dollars to their bottom line. It's why PBMs were so relieved when the Trump administration killed its drug rebate overhaul.

Go deeper: The drug rebate curtain

Go deeper

Mike Allen, author of AM
22 mins ago - Politics & Policy

Liz Cheney's plan to take on Trump

Cheney speaking to reporters after being removed as GOP conference chair yesterday. Photo: Kevin Dietsch/Getty Images

Rep. Liz Cheney (R-Wyo.) plans to make her purge the beginning of a new movement, with campaign travel, fundraising and speeches to challenge Donald Trump for ideological dominance of the GOP.

Driving the news: Sources in Cheney's camp tell me her message will be the importance of the truth, the need to move past Trump, and a push to articulate conservative policy and substance to combat Democrats.

Exclusive: Stephen and Ayesha Curry join One Million Black Women initiative

Stephen Curry and Ayesha Curry. Photo by Steve Jennings/Getty Images

Stephen and Ayesha Curry are joining the advisory council for Goldman Sachs' One Million Black Women initiative, Axios is first to report.

Why it matters: The initiative has committed to invest more than $10 billion in Black women over the next 10 years. It comes as banks and large companies are increasingly putting money behind rhetoric about advancing racial equity.

2 hours ago - Health

Axios Harris Poll 100: Pfizer, Moderna reputations soar post-vaccine

Data: Harris Poll; Chart: Danielle Alberti/Axios

America's affections have shifted away from the companies that helped us manage pandemic life and toward the vaccine manufacturers that are helping to end it.

Driving the news: Moderna and Pfizer shot up the ranks this year in the Axios/Harris 100, our annual survey of corporate reputations. Moderna is Americans' third-favorite company this year, and Pfizer came in at seventh — up from No. 61 a year ago.