Photo: George Frey/Getty Images

Wall Street panicked a little after the Trump administration rolled out its drug rebate proposal, but the stock prices of companies most at risk recovered because there’s still so much uncertainty about how the policy would change their businesses.

The big picture: The proposal would bar pharmacy benefit managers and insurers from accepting rebates from drug companies in Medicare and Medicaid under anti-kickback law. Instead, the two sides could work out fixed-fee arrangements, with rebates flowing directly from manufacturers to patients at the pharmacy counter.

Yes, but: The rule...

  • Would not immediately affect the commercial market, although HHS Secretary Alex Azar wants Congress to pass the proposal into law so it would apply everywhere.
  • Would not touch the other profitable tactics that PBMs have mastered, like spread pricing and generic drug algorithms.
  • Would take a swipe at a flawed rebate system, but push middlemen to raise premiums — which federal actuaries said could raise Medicare spending as much as $196 billion over the next decade.
  • Would almost certainly initiate a lawsuit on antitrust grounds.
  • Would "not have a meaningful impact on our growth or earnings trajectory," David Cordani, CEO of Cigna and its newly acquired Express Scripts, said on an earnings call Friday.

One thing that is pretty certain: Pharma wins. There’s no mandate to lower list prices, and drug companies would get to see competitors' rebates.

Go deeper: The Trump administration's major shakeup in the way we pay for drugs

Go deeper

Dion Rabouin, author of Markets
1 hour ago - Economy & Business

Investors are betting the future is priced in euros

Illustration: Aïda Amer/Axios

It's the euro's time now — at least that's how investors have been positioning recently.

What's happening: Speculators have raised their bets to the highest in nine years that the dollar will fall and increased bullish bets that the euro will rise to the highest level on record, Reuters reported citing data from the CFTC.

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Global: Total confirmed cases as of 9 a.m. ET: 20,372,619 — Total deaths: 743,344— Total recoveries: 12,609,775Map.
  2. U.S.: Total confirmed cases as of 9 a.m. ET: 5,141,879 — Total deaths: 164,545 — Total recoveries: 1,714,960 — Total tests: 63,252,257Map.
  3. Business: U.S. already feeling effects of ending unemployment benefits — U.S. producer prices rose last month by the most since October 2018.
  4. Public health: America's flying blind on its coronavirus response.
Mike Allen, author of AM
3 hours ago - Politics & Policy

3 keys to Joe Biden picking Kamala Harris

Photo: Jeff Kowalsky/AFP via Getty Images

Three quick points about Joe Biden's historic selection of Sen. Kamala (pronounced COMMA-luh) Harris of California as his running mate — and clues they give us to how Biden would govern:

  1. She was always at the top of his list. As I look back through my text threads with top Dems over the past five months, she was always assumed to be the most likely pick.