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FTC Targets PBMs In Lawsuit On Insulin Rebates But Says Pharma Also Culpable

 
• By Cathy Kelly

Although the FTC’s administrative complaint focuses only on insulins, the commission hopes it will have a broader impact by driving reforms of rebate and contracting practices for other drugs as well.

• Source: Alamy

A just-filed Federal Trade Commission legal action against pharmacy benefit managers CVS Caremark, Express Scripts and OptumRx and their group purchasing organizations for insulin rebating practices focuses solely on the PBMs. But the commission is also putting manufacturers on notice that they could be subject to enforcement action as well in the future.

Key Takeaways

  • FTC has filed an administrative complaint against the three leading PBMs and their group purchasing organizations claiming they engaged in unfair competition that impeded patient access to insulins and drove up patient costs.

  • The complaint is limited to the PBMs, but FTC separately noted it believes manufacturers are complicit in the problems that stemmed from insulin contracting and could be subject to enforcement action in the future

The PBMs “engaged in unfair methods of competition and unfair acts or practices under Section 5 of the FTC Act by incentivizing manufacturers to inflate insulin list prices, restricting patients’ access to more affordable insulins … and shifting the cost of high list price insulins to

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