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Reproduced from Adam Fein of the Drug Channels Institute; Chart: Axios Visuals

CVS Health, Express Scripts (now owned by Cigna) and OptumRx (owned by UnitedHealth Group) continue to control a vast majority of the drug insurance market, according to new estimates from Adam Fein of the Drug Channels Institute.

The bottom line: Those 3 pharmacy benefit managers handled more than 75% of all prescription claims in 2018.

The big picture: Employers usually don't switch drug benefits companies because they don't want to enrage their workers with the changes, which has given the big 3 players longstanding power in the market.

Go deeper: The data showing drug pricing games

Go deeper

Updated 1 hour ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 30,782,337 — Total deaths: 957,037— Total recoveries: 21,032,539Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 6,764,962 — Total deaths: 199,258 — Total recoveries: 2,577,446 — Total tests: 94,211,463Map.
  3. Politics: In reversal, CDC again recommends coronavirus testing for asymptomatic people.
  4. Health: The dwindling chances of eliminating COVID-19.
  5. World: Guatemalan president tests positive for COVID-19 — The countries painting their pandemic recoveries green.

The positions of key GOP senators on replacing Ruth Bader Ginsburg

Senate Majority Leader Mitch McConnell talks to reporters on Capitol Hill last Thursday. Photo: Chip Somodevilla/Getty Images

With President Trump planning to nominate his third Supreme Court justice nominee by next week, key Republican senators are indicating their stance on replacing the late Justice Ruth Bader Ginsburg just over six weeks out from Election Day.

The big picture: Senate Majority Leader Mitch McConnell (Ky.) has vowed that "Trump’s nominee will receive a vote on the floor of the United States Senate." But Sen. Lisa Murkowski (Alaska) told Alaska Public Media, "I would not vote to confirm a Supreme Court nominee. We are 50 some days away from an election."

Updated 3 hours ago - Politics & Policy

ActBlue collects a record $91 million in hours after Ginsburg's death

A makeshift memorial in honor of Justice Ruth Bader Ginsburg in front of the U.S. Supreme Court on Sept. 19. Photo: Samuel Corum/Getty Images

ActBlue received a record $91.4 million in the 28 hours following Supreme Court Justice Ruth Bader Ginsburg's death, the Democratic donation-processing site confirmed to Axios late Saturday.

Why it matters via the New York Times: "The unprecedented outpouring shows the power of a looming Supreme Court confirmation fight to motivate Democratic donors."