FTC Sues Major Pharmacy Benefit Managers Over Insulin Price Inflation

The Federal Trade Commission has filed a lawsuit against three major pharmacy benefit managers—Caremark, Express Scripts, and OptumRx—accusing them of anti-competitive practices that have inflated insulin prices. The FTC claims their rebate system artificially raises prices, impacting patients, especially those without insurance or with high deductibles. The PBMs deny the allegations.

The Federal Trade Commission has initiated legal action against three prominent pharmacy benefit managers, accusing them of engaging in anti-competitive practices that have driven up insulin prices for diabetic patients.

Caremark, Express Scripts, and OptumRx, which collectively manage around 80% of U.S. prescriptions, are alleged to have used a rebate system that inflates drug prices, according to the lawsuit filed on Friday.

Pharmacy benefit managers set up formularies and negotiate rebates off drug prices, but the FTC argues these practices have led to artificially high list prices and higher out-of-pocket costs for many Americans. The PBMs, however, dispute the charges, defending their role in controlling drug costs.

(With inputs from agencies.)