What if Medicare expands drug-price negotiation to 100 medicines?
Medicare negotiation expanding to 100 drugs with steep cuts compresses big-pharma terminal margins — a sector de-rating (large-cap pharma multiples), not a credit-crisis or crypto event. Rhymes with the August 2023 first-ten IRA list, which pressured the named franchises modestly while the index absorbed it. The Lehman-style risk-off cascade is wildly overstated; this is a slow-burn earnings-guidance grind, not systemic.
Every number ships with its receipt — the odds, the range, the precedents, and a public grade at Reality Check. The statistical machinery that produces it is proprietary.
The butterfly cascade
How this trigger trickles across markets, left → right — the root shock, its first‑order moves, then the ripple effects. Drag any node; tap a market for its real price history.
Resolution timeline — how this probability is moving
Our model's odds (electric blue) over time vs the market's (Polymarket, amber), from the past toward the 1–3 years horizon. Each dot is a real macro event that nudged the probability — green pushed it up, red pushed it down. Tap a dot for the source. Loading the probability audit trail…
What it would mean
If this plays out, it is a mixed shock. Medicare negotiation expands to 100 drugs with steep cuts, slashing big-pharma margins and chilling R&D guidance. The trigger decomposes into signed root‑shocks — Risk appetite ▼ — which propagate through our causal graph to the markets below.