The Federal Trade Commission (FTC) announced that it has filed a lawsuit against the nation’s three largest prescription drug benefit managers (PBMs) – Caremark Rx, Express Scripts (ESI), and OptumRx – and their affiliated group purchasing organizations (GPOs) for engaging in anticompetitive and unfair rebating practices that the FTC says have artificially inflated the list price of insulin drugs, impaired patients’ access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients.
The FTC alleges that these PBMs and their GPOs – which administer about 80% of all prescriptions in the U.S. – abused their economic power by rigging pharmaceutical supply chain competition to force patients to pay more for life-saving medication. The FTC asserts that the lynchpin of the scheme is a perverse drug rebate system that prioritizes high rebates from drug manufacturers, leading to artificially inflated insulin list prices. The complaint charges that even when lower list price insulins became available that could have been more affordable for patients, the PBMs systemically excluded them in favor of high list price, highly rebated insulin products. This scheme allegedly allowed the PBMs and their GPOs to inflate their profits.