FTC to Sue Major PBMs Over Insulin and Drug Prices Amid Anticompetitive Concerns

- The Federal Trade Commission (FTC) is planning to sue three major U.S. health companies, including Optum Rx, CVS Caremark, and Express Scripts, over their practices as pharmacy benefit managers (PBMs) that negotiate drug prices, including insulin.
- The FTC's lawsuits will focus on the business practices related to rebates that PBMs broker with drug manufacturers, aiming to uncover potential anticompetitive behaviors.
- The investigation, initiated in 2022, revealed that six major PBMs dominate nearly 95% of the prescriptions dispensed in the U.S., leading to concerns over rising prescription drug costs.
- The FTC's interim report criticized the top three PBMs for allegedly manipulating the drug supply chain for their gain at the expense of smaller pharmacies and patients.
- The Biden administration and Congress are pushing for more transparency in PBM operations to address the affordability challenges faced by many Americans.
- The legal action comes amid growing concerns over rising prescription drug costs, with the FTC's investigation also scrutinizing drug manufacturers.