Medicare

Pharmacy benefit managers pass along a lot of Medicare rebates

Prescription medicine staked on top of each other
Photo: Paul Linse/Getty Images

Pharmacy benefit managers negotiated $18 billion worth of rebates from drug manufacturers within Medicare’s prescription drug program in 2016, and they retained less than 1% of those rebates for themselves, according to a new Government Accountability Office report.

The big picture: This isn’t surprising, as Medicare is structured so that PBMs pass pretty much all rebates back to the federal government. While the GAO report offers a good base of how middlemen affect drug prices in Medicare, it does not fully address larger issues.

Hospitals winning big state battles

llustration of a giant health plus on top of a pile of cash, the ground underneath is cracking.
Illustration: Aïda Amer/Axios

Several states have made ambitious attempts to address health care costs, only to be thwarted by the hospital industry.

Why it matters: States' failures provide a warning to Washington: Even policies with bipartisan support — like ending surprise medical bills — could die at the hand of the all-powerful hospital lobby.