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Data: IQVIA Institute; Chart: Axios Visuals

The U.S. spent $344 billion on prescription drugs in 2018 — 4.5% more than the year before, according to pharmaceutical data firm IQVIA.

The big picture: Society collectively paid more for drugs last year, at a rate well above economic growth, because drugmakers launched new drugs with lofty price tags, sold more of their existing drugs, and raised prices on their blockbuster products.

Between the lines: Gross spending on drugs was $479 billion in 2018, but rebates and discounts collected by health insurance companies, pharmacy benefit managers and others in the supply chain lowered that amount by 28%, thus getting to the net figure of $344 billion.

The bottom line: Pharmaceutical companies and industry middlemen benefited from higher spending in 2018, even amid the furor from patients and lawmakers over unaffordable prescriptions.

  • And early federal data shows there's a chance net drug spending in 2019 may be rising at a similar rate.

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Updated 38 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

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  4. Education: What we overlooked in the switch to remote learning.
  5. Health: The dwindling chances of eliminating COVID-19 — 7 states set single-day coronavirus case records last week.
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Trump campaign goes all in on Pennsylvania

Trump poster in Scranton, Pennsylvania. Photo: Robert Nickelsberg/Getty Images

The president's campaign is placing more importance on Pennsylvania amid growing concern that his chances of clinching Wisconsin are slipping, Trump campaign sources tell Axios.

Driving the news: Pennsylvania, which has 20 electoral votes, twice Wisconsin's number, actually has been trending higher in recent public and internal polling, a welcome development for the campaign.

Inside Biden's Supreme Court strategy

Joe Biden enters the hall at the National Constitution Center. Photo: Roberto Schmidt/AFP via Getty Images

Joe Biden’s closing argument will shift to a dominant emphasis on health care, turning the looming Supreme Court fight into a referendum on coverage and pre-existing conditions, officials tell Axios.

Why it matters: Biden aides believed they were winning when the race was about the coronavirus pandemic. Now they plan to use the Supreme Court opening as a raucous new field for a health care fight, returning to a theme that gave Democrats big midterm wins in 2018.