Pharma's pricing power just isn't what it used to be, and it's probably not going to recover any time soon.

Pharmacy benefit manager (PBM) Express Scripts Holding Co. last week reported a record-low 1.5 percent increase in drug spending by commercial health insurance plans in 2017. It also said per-beneficiary drug spending fell for many commercial plans and gave a discouraging forecast — for drugmakers, anyway — for the years ahead.

Despite this top-line weakness, political pressure on drugmakers continues, threatening their bottom lines. 

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