Drug prices

America's health care economy keeps ballooning

Data: Centers for Medicare & Medicaid Services and CIA World FactBook; Note: All values adjusted for inflation as of 2018; Chart: Harry Stevens/Axios

Americans spent $3.65 trillion on health care in 2018, according to new preliminary estimates from independent federal actuaries. That total is about the same size as Spain and Canada's entire economies — combined.

Why it matters: U.S. health spending last year was 4.4% higher than in 2017, a rate that is still growing faster than the broader economy — which means more money is being taken out of people's paychecks to pay for a system that continues to worry and frustrate patients.

Ohio is fighting back against one of the nation's biggest PBMs

Ohio Attorney general dave yost
Ohio Attorney General Dave Yost. Photo: Justin Merriman/Getty Images

Ohio Attorney General Dave Yost has formally demanded that OptumRx, one of the country's largest pharmacy benefit managers, pay back $16 million in "overcharges" related to handling drug benefits for a state agency.

Why it matters: This isn't a lot of money in the grand scheme of things, but it's a forceful step that shows states are actively looking to claw back money from a PBM if they think the company is skimming too much profit from the drug pricing process.

Go deeper: States are the new battleground for drug middlemen

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