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American consumers may not have benefited all that much from the pharmaceutical components of trade deals, a new article in the New England Journal of Medicine argues.

The big picture: Starting with NAFTA, every U.S. trade agreement made since has included a pharmaceutical component.

Details: The article's authors — the Council on Foreign Relation's Thomas Bollyky and Brigham & Women's Hospital's Aaron Kesselheim — write that the inclusion of these provisions has had "a mixed record in delivering on its goals."

  • The Trump administration's NAFTA replacement — the USMCA — gives biologics 10 years of market exclusivity, a huge industry win.

By the numbers: The pharmaceutical trade deficit has swelled to $52 billion, and the number of Americans employed by the drug industry hasn't changed much since 2001.

  • The Food and Drug Administration estimates that we import 80% of active drug ingredients and 40% of finished drugs, and drug companies have increasingly shifted patents and manufacturing abroad to avoid paying U.S. taxes.
  • While our pharma industry is very profitable, we're also spending more for their brand products, while other countries are still paying less than us for drugs.

The bottom line: "Americans and their representatives are ignoring history if they expect the inclusion in the USMCA of longer exclusivity for biologics to redress the U.S. trade deficit, loss of manufacturing jobs, and high prescription-drug prices," the authors conclude.

Go deeper: Troubles ahead for Trump's NAFTA replacement

Go deeper

10 hours ago - World

Maximum pressure campaign escalates with Fakhrizadeh killing

Photo: Fars News Agency via AP

The assassination of Mohsen Fakhrizadeh, the architect of Iran’s military nuclear program, is a new height in the maximum pressure campaign led by the Trump administration and the Netanyahu government against Iran.

Why it matters: It exceeds the capture of the Iranian nuclear archives by the Mossad, and the sabotage in the advanced centrifuge facility in Natanz.

Scoop: Biden weighs retired General Lloyd Austin for Pentagon chief

Lloyd Austin testifying before Congress in 2015. Photo: Chip Somodevilla/Getty Images

Joe Biden is considering retired four-star General Lloyd Austin as his nominee for defense secretary, adding him to a shortlist that includes Jeh Johnson, Tammy Duckworth and Michele Flournoy, two sources with direct knowledge of the decision-making tell Axios.

Why it matters: A nominee for Pentagon chief was noticeably absent when the president-elect rolled out his national security team Tuesday. Flournoy had been widely seen as the likely pick, but Axios is told other factors — race, experience, Biden's comfort level — have come into play.

Updated 12 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: WHO: AstraZeneca vaccine must be evaluated on "more than a press release."
  2. Politics: Supreme Court backs religious groups on New York COVID restrictions.
  3. World: Thailand, Philippines sign deal with AstraZeneca for vaccine.
  4. Economy: Safety nets to disappear in December Black Friday shopping across the U.S., in photosAmazon hires 1,400 workers a day throughout pandemic.
  5. Education: National standardized tests delayed until 2022.

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