FTC Launches ‘Colonoscopy’ Into PBM Practices, Including Focus On Consumer Costs, Access

Study will examine how the six largest pharmacy benefit managers in the US handle 10 disease categories. Federal Trade Commissioners unanimously support inquiry after its scope was broadened from an earlier version that drew objections from Republicans.

FTC magnifying glass
Study Description Demonstrates FTC Interest In 'Trying To Get To The Bottom' Of Complaints Against PBMs • Source: Nielsen Hobbs; the Pink Sheet | Shutterstock images

The Federal Trade Commission is moving ahead with a comprehensive study into potentially anti-competitive practices by US pharmacy benefit managers by sending them compulsory orders seeking detailed information on rebate-driven formulary practices, their dealings with pharmacies and how they interact with affiliates, among other topics. The decision could be welcomed by the pharmaceutical industry, which has long tried to convince policymakers that PBMs are significant contributors to high drug prices. 

The order are going to CVS Health Corp., Express Scripts Holding Company, OptumRx Inc., Humana Inc. Pharmacy Solutions, Prime Therapeutics and MedImpact Healthcare Systems. All but...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required

More from Pricing Debate

US ‘Most Favored Nations’ Drug Pricing Policy Will Jeopardize Innovation In Europe

 

The US MFN executive order is the latest in a series of concerning US developments that are contributing to uncertainty for the European pharmaceutical industry, according to France Biotech’s vice president, Alexandre Regniault.

Japan Price Cuts For Epkinly and Lunsumio Following CEA

 
• By 

Japan is cutting more drug reimbursement prices following cost effectiveness analysis and is applying the methodology to a new group of products including Wegovy and Leqembi.

GLP-1 Pricing ‘Paradigm Shift’ Possible, But Would It Meet Trump’s MFN Goals?

 
• By 

For the Trump Administration, the blockbuster GLP-1 drugs for obesity have become a poster child for the disparity between US and foreign prices.

Could EU Collective Procurement Counter US Most Favored Nation Policy?

 

Joint procurement, if used by member states to respond to potential pricing and access challenges caused by a US most favored nations pricing policy, would cause more uncertainty for pharmaceutical companies, warn industry representatives.

More from Market Access

Rocky Rollout Spells Trouble for Medicare Prescription Payment Plan

 

Enrollment in the new Medicare Prescription Payment Plan was lower than expected in the first year and well below CMS expectations, and invoicing data indicates members are slow to pay.

PBM Investigation, Enforcement Action ‘Critical Priorities’ At FTC, Chair Says

 
• By 

The new FTC chair addressed concerns that staffing cuts will undermine the commission’s commitment to pharmacy benefit manager oversight.

US FDA’s Familiar Drug Pricing To-Do List

 

President Trump’s new Executive Order on drug pricing reprises several policy themes from his first administration, including giving the FDA many tasks intended to increase competition in the marketplace.