Good morning. Welcome to Axios today. It's Tuesday, December 7th. I'm Nyla Boudou. Here's

what we're watching today. The Department of Justice who's Texas overvoting rights. Plus,

eating out could soon mean more encounters with robots. But first, the complicated web of

employer drug pricing is today's one big thing.

Americans spend hundreds of billions on prescription drugs each year. In fact, about $370 billion

as of 2019, and employers in charge of health care plans paid for about $166 billion of that.

It's middleman firms which actually negotiate these drug prices on behalf of employers, but

because they keep their data secret, companies have no idea whether they're getting a fair deal

on drug prices or not. And in Axios investigation shows these intermediaries are working hard

to keep it that way. Bob Herman is Axios' health care business reporter. Hey, Bob.

Hey, Nyla. So this is kind of complex. If I go to a pharmacy and I pick up a prescription

that's covered by my employer, who's negotiated that price?

Yeah, there's a lot of action that occurs behind the pharmacy kind of companies that most

Americans have never heard of specifically in our investigation. We're referencing what's

called a drug pricing coalition. So imagine your employer goes to a consulting firm.

This consulting firm helps with benefits and what kind of plans they should offer to their

employees. And then they go to what's called pharmacy benefit managers. And these PBMs

essentially are the companies that negotiate drug prices with drug manufacturers that decide

which drugs get preferential treatment. We focus specifically on a drug pricing coalition

that is started by Aeon. Aeon is this big global benefits firm. Now they charge employers

anywhere from $20,000 a year up to $300,000 a year just to be part of the coalition. And you

get to supposedly benefit from the prices that are negotiated as being part of it.

...