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Source: Bureau of Economic Analysis; Chart: Axios Visuals 

Gross prescription drug spending appears to be on the rise. Preliminary data from the Bureau of Economic Analysis shows the amount spent on prescriptions in the first quarter of 2019 increased 7.1% year over year, the highest annualized growth rate since the fourth quarter of 2015.

Yes, but: The data points do not factor in the rebates and discounts that drug manufacturers pass along to industry middlemen. So that higher spending rate doesn't tell the full story, and real spending growth almost certainly is lower.

Details: The BEA will revise these numbers twice by June, but they still won't account for drug rebates.

  • Data from the Centers for Medicare & Medicaid Services, which accounts for rebates but takes longer to come out, remains the gold standard for tracking prescription drug spending.
  • CMS found spending growth for retail prescriptions was essentially flat in 2017 and estimates the final growth rate in 2018 will be 3.3%. CMS predicts net drug spending will rise by 4.6% in 2019.

The bottom line: "The rebate issue really makes a mess of these things," said Paul Hughes-Cromwick, a health economist at research firm Altarum. Until the federal government gets real-time rebate data from drugmakers or pharmacy benefit managers, he said, "we're all running around chasing our tails."

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In photos: Virginians line up for hours on first day of early voting

Photo: Andrew Caballero-Reynolds/AFP via Getty Images

In some parts of Virginia, people waited in line up to four hours to cast their ballots on the first day of early voting, according to the Washington Post.

The big picture: The COVID-19 pandemic seems to already have an impact on how people cast their votes this election season. As many as 80 million Americans are expected to vote early, by mail or in person, Tom Bonier, CEO of TargetSmart, a Democratic political data firm, told Axios in August.

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Coronavirus dashboard

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  2. U.S.: Total confirmed cases as of 4:30 p.m. ET: 6,705,114 — Total deaths: 198,197 — Total recoveries: 2,540,334 — Total tests: 92,163,649Map.
  3. Politics: In reversal, CDC again recommends coronavirus testing for asymptomatic people.
  4. Health: Massive USPS face mask operation called off The risks of moving too fast on a vaccine.
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  6. Education: At least 42% of school employees are vulnerable.

Court battles shift mail-in voting deadlines in battleground states

Illustration: Sarah Grillo/Axios

Michigan joins Pennsylvania in extending mail-in ballot deadlines by several days after the election, due to the coronavirus pandemic and expected delays in U.S. Postal Service.

The latest: Michigan Court of Claims Judge Cynthia Stephens ruled that all ballots postmarked before Nov. 2 must be counted, so long as they arrive in the mail before election results are certified. Michigan will certify its general election results on Nov. 23.