FTC Chairman Lina Khan testifies during a hearing of the House Financial Services and General Government Appropriations Subcommittee entitled “Federal Trade Commission Fiscal Year 2025 Requests” in the Rayburn Building on Wednesday, May 15, 2024.
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The U.S. Federal Trade Commission is planning to sue three major U.S. health care companies, accusing them of acting as middlemen to negotiate prices for drugs such as insulin, driving up patient costs, a person familiar with the matter told CNBC on Wednesday.
The lawsuits are expected to target three major so-called pharmacy benefit managers, UnitedHealth GroupOptum Rx, CVS Healthcare markings and CignaSources say Express Scripts confirmed Earlier Wall Street Journal report Wednesday about the agency’s plans. All three companies are owned by or related to health insurance companies.
The lawsuits will specifically focus on business practices related to PBM brokering of kickbacks to drug manufacturers, the Wall Street Journal reported, citing people familiar with the matter.
A CVS Caremark spokesperson said in a statement Wednesday that the company is “proud of the work we are doing to make insulin more affordable for all Americans with diabetes, and we stand up to protect American businesses, unions and patients from exempt Record “Drug Prices Affected by Increased Prescription Volume.” “
On February 7, 2024, a customer visited a CVS Pharmacy in Miami, Florida.
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A spokesperson for Express Scripts said, “The price of insulin and other drugs is set by manufacturers, and they have raised list prices multiple times.” They added that Express Scripts is committed to “fighting the high prices of the pharmaceutical industry and lowering prices for patients and their families.” The cost of thousands of medications for health plans, the data shows we are succeeding.”
The FTC declined to comment on the reported lawsuit. A spokesman for Optum Rx did not immediately respond to a request for comment.
The FTC probe into insulin prices has also put drugmakers under scrutiny, but it’s unclear whether they will be named in the upcoming lawsuit, Politico The report said, citing sources. Eli Lilly and CompanyFrench pharmaceutical company Sanofi and Danish Pharmaceuticals Novo Nordisk Controls approximately 90% of the insulin market in the United States.
PBMs are at the center of the U.S. drug supply chain, negotiating rebates with drug manufacturers on behalf of insurance companies, large employers and others. They also create a list (or formulary) of drugs covered by insurance and reimburse pharmacies for prescription costs.
Pharmacist Thomas Jensen checks prescription medications at Rock Canyon Pharmacy in Provo, Utah, on May 9, 2019.
George Frey | Reuters
The U.S. Federal Trade Commission released Tuesday scathing interim report Based on its ongoing multi-year investigation of PBMs. The report slams the three major pharmacy benefit managers for manipulating the drug supply chain to enrich themselves at the expense of small independent pharmacies and costly American patients.
The FTC reports that the six largest PBMs handle nearly 95% of prescriptions in the United States. Its investigation begins in 2022.
PBMs hold manufacturers responsible for high drug prices, while drugmakers say rebates and fees charged by these middlemen force them to raise the list prices of their products.
With many Americans struggling to afford prescription drugs, the Biden administration and Congress have stepped up pressure on the Pharmacy Benefits Administration, seeking to make its operations more transparent. Americans pay on average two to three times more for prescription drugs than patients in other developed countries, according to one survey. Overview From the White House.
The Inflation Reduction Act signed by President Biden caps insulin prices for Medicare beneficiaries at $35 per month. The policy is not currently available to patients with private insurance.
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