The Federal Trade Commission has filed a lawsuit against three major pharmacy benefit managers (PBMs) for allegedly engaging in anticompetitive and unfair practices that have led to inflated insulin prices. The “Big Three” PBMs named in the lawsuit are UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts. The FTC claims that these PBMs, along with their group purchasing organizations, have prioritized high rebates from drug manufacturers, resulting in higher list prices for insulin drugs. Around 8 million Americans rely on insulin and have been impacted by these practices.
The PBMs deny the allegations, with CVS Caremark stating that they have worked to drive down the cost of insulin for all patients. Cigna also disputed the lawsuit, accusing the FTC of launching ideologically driven attacks against pharmacy benefit managers. The FTC argues that not only are the PBMs responsible for the rising insulin prices, but also the drug manufacturers themselves, such as Eli Lilly and Novo Nordisk.
The National Community Pharmacists Association supported the FTC’s lawsuit, criticizing the PBMs for manipulating the system against patients, taxpayers, and small pharmacies. Lawmakers from both parties have also raised concerns about the role of PBMs in driving up drug prices. The lawsuit is part of a broader investigation into PBMs’ impact on healthcare costs, as states, including Vermont, have also sued PBMs for driving up drug costs.
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