The Federal Trade Commission will sue three major US health companies over practices that allegedly inflate medication prices, including insulin.
The targeted companies are the largest pharmacy benefit managers (PBMs): UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts.
All of these firms are connected to health insurers.
The lawsuits will focus on the business practices related to the rebates PBMs negotiate with drug manufacturers.
These practices are alleged to contribute to higher costs for patients.
A CVS Caremark spokesperson said the firm is “proud of the work we have done to make insulin more affordable for all Americans with diabetes, and we stand by our record of protecting American businesses, unions, and patients from rising prescription drug prices.”
An Express Scripts spokesperson said the “prices of insulin and other medicines are set by their manufacturers, who have raised list prices repeatedly.”
They added Express Scripts works to lower the cost of thousands of medicines for patients and their health plans.
Optum Rx has yet to comment on the lawsuits.
The FTC has been investigating PBMs since 2022, focusing on insulin prices and the role of drugmakers
The FTC also declined to comment on the matter.
PBMs play a crucial role in the US drug supply chain by negotiating rebates with drug manufacturers on behalf of insurers and large employers.
They create lists of medications covered by insurance and reimburse pharmacies for prescriptions.
The FTC has been investigating PBMs since 2022, particularly focusing on insulin prices and the role of drugmakers.
Those include Eli Lilly, Sanofi, and Novo Nordisk, who control about 90 percent of the US insulin market.
A recent interim FTC report accused the three largest PBMs of manipulating the drug supply chain to their benefit, negatively impacting smaller pharmacies and US patients.
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The report noted that six of the largest PBMs handle nearly 95 percent of US prescription fills.
PBMs argue that manufacturers are to blame for high drug prices.
Drugmakers claim that the fees and rebates collected by PBMs force them to raise list prices.
The Biden administration and Congress are increasing pressure on PBMs to enhance transparency as Americans continue to face high prescription drug costs.
President Biden’s Inflation Reduction Act has capped insulin prices for Medicare beneficiaries at $35 per month.
However, this policy does not extend to patients with private insurance.
