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Data: IQVIA, company financial documents; Note: Data has been corrected for Biktarvy, Enbrel, Januvia, Remicade and Stelara (more info below). Chart: Andrew Witherspoon/Axios

The 10 highest-selling drugs in the U.S. last year gave away more than $23 billion in rebates to insurance intermediaries, but still netted $50 billion in sales.

The big picture: The U.S. drug pricing system is filled with confusing numbers, and many entities profit off the flow of drugs, but pharmaceutical companies retain a vast majority of the proceeds.

By the numbers: Humira, the rheumatoid arthritis blockbuster made by AbbVie, continues to generate more revenue than any other drug, due to AbbVie extending U.S. patents and consequently retaining higher U.S. prices.

  • After subtracting about $3 billion in discounts that went to drug distributors and other supply chain entities, Humira generated about $21.4 billion in "non-discounted invoice sales," according to a report from data analytics firm IQVIA.
  • Another $6.5 billion in rebates went to pharmacy benefit managers, health insurers and employers, leading to $14.9 billion in net U.S. Humira sales for AbbVie.

Between the lines: Drugs that have more competitors usually offer higher insurance rebates than drugs with few or no competitors.

  • Intravenous cancer drug Keytruda has few competitors and is used for several conditions, and therefore doesn’t have large rebates.
  • Blood thinners Xarelto and Eliquis and diabetes drug Trulicity are battling several other drugs in their classes, and therefore offer rebates well over 50% of their list prices to get preferred slots on lists of covered drugs.

Editor’s note: This story and chart have been corrected to show there was roughly $50 billion (not $58 billion) in U.S. net sales. We had previously included international sales for Biktarvy, Enbrel, Januvia, Remicade and Stelara.

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Voters approved legalizing recreational marijuana use in several states, and Oregon decriminalized the possession of street drugs.

The big picture: New Jersey, Arizona, Montana and South Dakota will join the 11 states and D.C. that have already legalized cannabis for adult recreational use.

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64% of people from around the world say climate change is a global emergency, a United Nations poll published Wednesday finds.

Why it matters: It's biggest global survey on climate change ever conducted, with some 1.2 million participants from 50 countries — including the U.S. where 65% of those surveyed view climate change as an emergency.

Collins helps contractor before pro-Susan PAC gets donation

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A PAC backing Sen. Susan Collins in her high-stakes reelection campaign received $150,000 from an entity linked to the wife of a defense contractor whose firm Collins helped land a federal contract, new public records show.

Why it matters: The executive, Martin Kao of Honolulu, leaned heavily on his political connections to boost his business, federal prosecutors say in an ongoing criminal case against him. The donation linked to Kao was veiled until last week.