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NEW YORK — The U.S. Federal Trade Commission is planning to sue UnitedHealth, Cigna and CVS Health — the three largest pharmacy-benefit managers — over their tactics for negotiating prices for drugs including insulin, the Wall Street Journal reported today.
The FTC plans to file lawsuits targeting business practices related to rebates brokered with drug manufacturers, the report said, citing a person familiar with the matter.
This move comes a day after the FTC issued an interim report stating that the three biggest PBMs—managing 79% of U.S. prescription drug claims—have greatly enriched themselves at the expense of smaller pharmacies and consumers. That interim report prompted National Association of Chain Drug Stores president and CEO Steven Anderson to issue a call for action. “The FTC’s initial findings in its study of PBM tactics provide further evidence of the dire need for action at the federal and state levels,” Anderson said in a statement.
A CVS Health spokesperson argued that the company has actually helped reduce the costs of insulin and other prescription medications.
“We have led the way in driving down the cost of insulin for all patients: insured, uninsured, and underinsured. Our members on average pay less than $25, far below list prices and far below the Biden Administration’s $35 cap,” the spokesperson said. “Further, we also provide access to $25 insulin to every American, whether insured or uninsured, through our ReducedRx program at every one of our 67,000 network pharmacies and more than 9,000 CVS pharmacies.
“Three brand drugmakers control nearly the entire insulin market, and without competitive biosimilar alternatives, they raised their list prices by as much as 500% in lockstep with one another prior to 2012. That’s when CVS Caremark fueled increased competition by creating new formulary options to fight back against these manufacturer price hikes. We negotiated deep discounts on behalf of our clients – American businesses large and small, unions, and local, state, and federal government plans – and embraced the launch of the first insulin biologic, helping bring insulin back to affordable levels for their members.
“Any action that limits the use of these PBM negotiating tools would reward the pharmaceutical industry and return the market to a broken state, leaving American businesses and patients at the mercy of the prices drugmakers set. We will defend the use of these tools vigorously as we continue working to safeguard our clients and their members from drugmaker price gouging,” the spokesperson added.
