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FTC Criticizes PBMs for Inflating Drug Prices, Prepares Lawsuit Over Insulin Against UnitedHealth, Cigna, CVS

Jul 9, 2024, 08:30 PM

The Federal Trade Commission (FTC) has released an interim 71-page report criticizing pharmacy benefit managers (PBMs) for inflating drug prices and harming independent pharmacies. The report highlights that PBMs, which manage nearly 80% of U.S. prescriptions, have overcharged for cancer drugs and other medications. The FTC found that PBMs paid their own mail-order pharmacies up to 200 times more than rival pharmacies for the same drugs. The report also notes that market consolidation has led to a few PBMs wielding significant power over drug prices. In 2016, combined revenue of PBMs was $456 billion, which increased to over $1 trillion in 2023. The FTC is now preparing to sue the three largest PBMs—UnitedHealth Group’s OptumRx, Cigna Group’s Express Scripts, and CVS Health’s Caremark—over their tactics for negotiating prices for insulin and other drugs. This move marks a significant shift in the FTC’s approach, signaling increased scrutiny and potential regulation of PBMs.