The FTC claims the three major PBMs engaged in unfair practices by favoring higher-priced insulin with larger rebates
The Federal Trade Commission announced a lawsuit against three major pharmacy benefit managers (PBMs) that negotiate drug prices—UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts—accusing them of artificially inflating insulin prices for patients.
The FTC claims that the “Big Three” engaged in unfair practices by favoring higher-priced insulin with larger rebates so they could take the cash drug companies gave back, affecting around 8 million Americans who depend on the medication.
PBMs earn revenue through negotiated rebates and fees from drug manufacturers, which are tied to a drug’s list price.
Together, these PBMs manage about 80% of US prescription drug plans, creating a system prioritizing high manufacturer rebates.