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Illustration: Aïda Amer/Axios

Winning over employers is the biggest hurdle facing two new drug benefits companies — one created by billionaire Mark Cuban's startup drug firm and another created by a coalition of large employers.

Why it matters: The projects won't go far if major employers don't shift their business away from the dominant incumbents to these new firms.

The big picture: Three pharmacy benefit managers — Express Scripts, CVS Caremark and OptumRx — control roughly 80% of the market.

Yes, but: Large companies like Boeing, Disney, Intel and Walmart make up the Purchaser Business Group on Health, which is starting a PBM called EmsanaRx. "The industry has really been unresponsive to their concerns," said Elizabeth Mitchell, PBGH's CEO.

  • PBGH can't force its member companies to end or switch their PBM contracts, but the group is "very encouraged" about winning employers during open bids, Mitchell said.

The bottom line: These new companies are looking to strip away the games within drug pricing contracts, like rebates and spread pricing. There's a big appetite for change, but success ultimately will depend on employers ditching the current oligopoly.

Go deeper: The drug pricing contract Express Scripts doesn't want you to see

Go deeper

Vaccine rule gives businesses cover

Illustration: Brendan Lynch/Axios

The White House issued its rules on worker vaccine mandates for companies with 100 or more employees Thursday. 

Why it matters: The rules provide clarity for companies, but they could add to strains in the labor market.

Nov 5, 2021 - Health

Health insurers still aren't that worried about the coronavirus

Hospitals workers care for a COVID-19 patient. Photo: Apu Gomes/AFP via Getty Images

COVID-19 has affected each health insurance company differently, but the industry remains mostly insulated from the virus' growing toll.

The big picture: Most of the big insurers have sidestepped massive coronavirus-related costs so far this year, due in large part to people putting off other care. And the companies that have had to pay more medical claims are raising premiums on employers and consumers, exactly as they said they would.

Dan Primack, author of Pro Rata
Updated 11 mins ago - Politics & Policy

Trump social media group raises $1 billion from undisclosed investors

Illustration: Sarah Grillo/Axios

Donald Trump's social media startup on Saturday announced that it secured $1 billion in new investment as part of its ongoing efforts to become publicly traded via a blank check company.

Between the lines: None of the investors were identified, which is highly unusual for this sort of transaction.