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

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Coronavirus cases rise in 33 states

Data: The COVID Tracking Project, state health departments; Map: Andrew Witherspoon, Sara Wise, Naema Ahmed, Danielle Alberti/Axios

The coronavirus pandemic keeps getting worse, all across the country. Thirty-three states saw their caseloads increase this week, continuing a scary nationwide trend that’s been getting worse since mid-June.

Why it matters: The U.S. is right back in the situation we were afraid of earlier this year, with a rapidly spreading outbreak, strained hospitals, and projections of more than 200,000 deaths by the end of the year.

Updated 7 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Global: Total confirmed cases as of 10 p.m. ET: 12,009,301 — Total deaths: 548,799 — Total recoveries — 6,561,969Map.
  2. U.S.: Total confirmed cases as of 10 p.m. ET: 3,053,328 — Total deaths: 132,256 — Total recoveries: 953,420 — Total tested: 37,532,612Map.
  3. Public health: Houston mayor cancels Republican convention over coronavirus concerns Deaths are rising in hotspots — Déjà vu sets in as testing issues rise and PPE dwindles.
  4. Travel: United warns employees it may furlough 45% of U.S. workforce How the pandemic changed mobility habits, by state.
  5. Education: New York City schools will not fully reopen in fallHarvard and MIT sue Trump administration over rule barring foreign students from online classes.
  6. 🎧 Podcast: A misinformation "infodemic" is here.

Transcripts show George Floyd told police "I can't breathe" over 20 times

Photo: Gary Coronado/Los Angeles Times via Getty Images

Newly released transcripts of bodycam footage from the Minneapolis Police Department show that George Floyd told officers he could not breathe more than 20 times in the moments leading up to his death.

Why it matters: Floyd's killing sparked a national wave of Black Lives Matter protests and an ongoing reckoning over systemic racism in the United States. The transcripts "offer one the most thorough and dramatic accounts" before Floyd's death, The New York Times writes.