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Even in the complicated ecosystem of drug pricing, one fact stands out: $166 billion in discounts from pharmaceutical companies go directly into the coffers of pharmacy benefit managers. That’s 37% of our nation’s entire expense on drugs. Not a single dollar of that largesse is used to reduce patients’ out-of-pocket costs when they need medicines. So when the White House boldly developed a rule to change the dynamic by banning many rebates drug companies pay to pharmacy benefit managers under Medicare, policy experts applauded. That proposed rule died last night, the victim of intense lobbying and general ignorance. Who loses? Patients. Who wins? The status quo. (Peter J. Pitts, 7/11)

President Donald Trump’s efforts to make good on promises to lower prescription-drug costs suffered a couple of major setbacks this week. With luck, though, these reversals may clear a path for better solutions.  A judge started the week by derailing a Trump administration plan to force drugmakers to disclose the high list prices of their medicines in TV ads. Then, late Wednesday, the White House confirmed it is scrapping an ambitious effort to change how the government pays for drugs. The now-dead plan called for eliminating some of the rebates received by pharmacy benefit managers (PBMs) – the middlemen that negotiate drug costs for health plans. (Max Nisen, 7/11)

Ohio politicians have paid a lot of lip service in the past year to address the damage done to health care by pharmacy benefit managers. But now, 16 months after The Dispatch first reported on CVS Caremark’s abusive pricing strategy, one element of the current Statehouse budget stalemate suggests lawmakers aren’t serious about fixing the problem. The House- and Senate-passed versions of the 2020-21 budget have different language for reforming state contracts with PBMs, and that is one of the differences that must be resolved to pass a budget. A first question to ask is why this thorny, complicated problem is even part of the state budget bill. (7/10)