D.C. readers! You're invited to Shifting the Wellness Paradigm, tomorrow at 8 am.
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, Axios' Bob Herman writes.
The biggest threat for PBMs is the Trump administration's proposal to eliminate the rebates they collect 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.
Freshman GOP Sens. Rick Scott and Josh Hawley introduced a new drug pricing bill last week that could have been written by Bernie Sanders, and it's not being attacked by GOP leadership.
What they're saying: "I’m sure [Pharma] hate[s] it," Hawley told me. "But look, they're not good actors. I mean, Big Pharma has gotten a sweetheart deal, they’ve gotten huge, they’ve gotten powerful, they’ve gotten rich, and I’m not terribly sympathetic to their position on this."
My thought bubble: If you haven't yet been convinced that the politics surrounding drug prices has changed, think again.
Administrative costs make up a much larger share of health care spending in the U.S. than in other high-income countries, according to a new analysis by the Center for American Progress.
By the numbers: Of the $496 billion spent a year by health insurers and providers on billing and insurance-related costs — and then passed on to consumers — CAP estimates that $248 billion is unnecessary.
One of the reasons it's proving so difficult to find a cure for Alzheimer's is because the disease often coexists with other brain abnormalities, NYT reports.
Why it matters: It's essentially impossible to find a cure for a condition that isn't concretely defined.
The number of measles cases this calendar year has jumped to 465, the Centers for Disease Control and Prevention announced yesterday.
Have a great Tuesday!