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Illustration: Shoshana Gordon/Axios

Prescription drugs — which represent just 10% of national health spending — have remained a persistent issue on Capitol Hill for a reason.

The big picture: The 10% number doesn’t tell the full story. Retail drug spending represents 18% of health benefit costs for large employers, even after taking rebates from drug manufacturers into account.

  • They also represent 19% of out-of-pocket costs for Medicare beneficiaries and 17% of out-of-pocket costs for workers.
  • Especially hard hit are people in fair or poor health who use more drugs. Nearly half (49%) of that group say they have difficulty paying for their drugs.

There’s been much focus in Washington on how much Medicare negotiation of drug prices could save the federal budget, and what those savings could be used to pay for.

  • Yet, what makes drug price negotiation a powerful idea — with bipartisan support from more than 80% of the public — is not the budgetary savings policymakers covet. It’s the potential to lower costs for patients and businesses paying for health benefits.

Driving the news: HR 3 and the principles for drug cost legislation recently released by Senator Wyden would give employer plans and privately insured people access to government negotiated prices, in addition to Medicare and its beneficiaries.

  • Polling shows that criticisms made by industry that drug price negotiation could reduce the availability of drugs and research and development on new drugs could erode support. But those criticisms have been made for years and have not sunk in.
  • The staying power of the idea and the number of people who would benefit continues to drive many Democrats to try to get drug price negotiations passed.
  • That’s also why PhRMA will oppose these proposals with everything at its disposal.

Meanwhile, there is one incidental winner from the current debate about drug costs, America’s hospitals. They represent 31.4% of health spending and the focus on drug costs keeps them out of the crosshairs.

Go deeper

Oct 1, 2021 - Health

Before Merck backed COVID antiviral, Trump admin turned it down

Photo illustration: Igor Golovniov/SOPA Images/LightRocket via Getty Images

Trump administration officials fought over whether — and ultimately declined — to fund the same antiviral drug that Merck announced yesterday significantly reduces hospitalizations and deaths among coronavirus patients.

Why it matters: The Trump administration's decision almost certainly delayed the development of the drug. Having an effective antiviral pill during the Delta wave could have substantially reduced its death toll.

Defense taking steps to mitigate civilian harm after botched airstrikes

Secretary of Defense Lloyd Austin speaks during a news conference at the Pentagon in Arlington, Virginia on Sept. 1, 2021. Photo: Andrew Harrer/Bloomberg via Getty Images

Defense Secretary Lloyd Austin issued a directive Thursday to improve the U.S. military's approach to civilian harm mitigation and response, calling it a "strategic and a moral imperative."

Why it matters: The Pentagon has faced criticism for years for amassing civilian casualties in its missions, especially in the Middle East. New York Times investigations have found systemic failures in efforts to prevent civilian deaths, as well as a cover-up of a 2019 airstrike that killed dozens of women and children in Syria.

2 hours ago - World

Mapped: The world's most and least corrupt countries

Expand chart
Data: Transparency International; Map: Jared Whalen/Axios

The most corrupt governments in the world are in South Sudan, Syria and Somalia, according to Transparency International's annual index, while the "cleanest" are in Denmark, Finland and New Zealand.

  • Breaking it down: The U.S. is 27th, China 66th, India 85th, Brazil 96th and Russia 136th. Scroll over the map to see each country's ranking.