Pharmaceutical companies

The complicated politics of Trump's rebate rule

HHS Sec Alex Azar and President Trump
Health and Human Services Sec. Alex Azar with President Trump. Photo: Alex Wong/Getty Images

The Trump administration's proposal to shake up how money moves through the prescription drug supply chain in Medicare works best if it's also extended to the commercial market, supporters say.

Yes, but: The politics of the proposal will almost certainly prevent this from happening. Opponents say the change is a handout to pharmaceutical companies and would increase premiums, and analyses of the proposal — including the government's — support this argument.

Pharma's bad behavior is causing its own problems

Illustration of two pill bottles in handcuffs
Illustration: Rebecca Zisser/Axios

The pharmaceutical industry is under fire in the public eye, in Congress and in the courts. And it mostly brought this on itself — through price hikes, allegedly anticompetitive behavior and aggressive opioid marketing.

The big picture: There's a real debate to be had about the value of new, innovative, sometimes life-saving drugs. But the industry has clouded its own argument, and weakened its own political standing, through a slew of bad behavior.