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Market
Will any accused PBM announce a change in pricing policy for specialty drugs by December 31, 2025?
2
Resolution / Starting Odds
Yes • 50%
No • 50%
Official announcements from CVS, UnitedHealth, or Cigna
Story
FTC Accuses CVS, UnitedHealth, Cigna of Marking Up Specialty Drug Prices for Cancer, HIV, Heart Disease, Generating $7.3 Billion
Jan 14, 2025, 05:21 PM
The Federal Trade Commission (FTC) has released a report accusing the three largest pharmacy benefit managers (PBMs) in the U.S.—CVS Health's Caremark, UnitedHealth Group's OptumRx, and Cigna's Express Scripts—of marking up the prices of specialty generic drugs, generating an estimated $7.3 billion in revenue from 2017 to 2022. The report highlights that these PBMs marked up the prices of drugs used to treat serious conditions such as cancer, HIV, and heart disease by hundreds or thousands of percent at their affiliated pharmacies. FTC Chair Lina Khan stated that the agency should continue to investigate practices that may inflate drug costs and act swiftly to stop any illegal conduct. The findings suggest that these markups have contributed to higher overall healthcare costs and have impacted independent pharmacies negatively.
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UnitedHealth’s OptumRx • 33%
None • 1%
CVS Health’s Caremark • 33%
Cigna’s Express Scripts • 33%
Cigna’s Express Scripts • 33%
None • 1%
UnitedHealth’s OptumRx • 33%
CVS Health’s Caremark • 33%
OptumRx • 25%
Express Scripts • 25%
CVS Caremark • 25%
Other • 25%
Cigna • 25%
UnitedHealth • 25%
No settlement • 25%
CVS Health • 25%
Cigna • 33%
No significant reduction • 1%
CVS • 33%
UnitedHealth • 33%
CVS Health • 25%
Express Scripts • 25%
Other • 25%
OptumRx • 25%
Yes • 50%
No • 50%
