On September 20th, 2024, the Federal Trade Commission (FTC) filed a complaint against Express Scripts, CVS Caremark, and OptumRx – the three pharmacy benefit mangers (PBMs) responsible for administering approximately 80 percent of prescription drugs in the U.S. The complaint alleges the PBMs are inflating insulin prices through anticompetitive practices.
In the complaint, the FTC alleges that CVS Caremark, Express Scripts, and OptumRx implemented a perverse rebate system that artificially raised insulin prices for their own profit while patients struggled with higher costs. Specifically, it alleges that as the list price for insulin rose, PBMs collected rebates that, theoretically, should have substantially lowered the cost of insulin for patients at the pharmacy counter. However, despite collecting these rebates, some patients are still paying the full, unreduced list price — not receiving any benefit from the rebates collected.
This lawsuit follows the FTC’s July 2024 report that found the six largest PBMs wield significant power over drug accessibility and pricing. In response to the report, Express Scripts’ recently brought an action against the FTC, seeking the retraction of the FTC’s July 2024 report, which it claims is false, misleading, and harmful to the PBM industry.
Learn more here. Read the FTC’s complaint.
Last Updated on October 7, 2024 by Aimed Alliance
