The Federal Trade Commission plans to sue the three largest pharmacy benefit managers over their negotiating tactics for various medicines, including insulin, that pushed patients toward higher-priced treatments, according to a source familiar with the matter.
The step comes after the agency this week released a scathing report that found the three largest PBMs — Express Scripts, Caremark, and OptumRx — processed nearly 80% of the roughly 6.6 billion prescriptions that were dispensed by U.S. pharmacies in 2023. The FTC said its findings were interim, though, because some companies did not provide all of the requested information and threatened further action.
In its report, the FTC argued that the largest PBMs wield such “enormous power” that the companies can affect the ability of many Americans to access and afford their medicines. The agency also found that the prescription drug market is “highly concentrated” because the largest PBMs are owned by insurers and, in turn, own specialty, mail-order, or retail pharmacies, which throttles competition.
