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. 

Spending growth remains strong in some treatment areas. Spending on cancer drugs, for which pricing tends to be aggressive, increased 17.4 percent in 2017. Inflammation-drug prices jumped 15.3 percent as new and expensive new drugs launched and prices for older drugs kept rising. 

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