The Federal Trade Commission has issued a scathing report criticizing pharmacy benefit managers for potentially inflating drug costs and harming independent pharmacies. This marks a significant shift in the agency’s approach under Chair Lina Khan, who has previously taken a more hands-off stance towards these companies.
While the F.T.C. has not taken any enforcement actions against benefit managers yet, the industry is concerned that the report could lead to investigations or lawsuits alleging anticompetitive behavior. Additionally, the findings may spur lawmakers at both the federal and state levels to consider regulations to curb the power of benefit managers.
The three largest benefit managers in the U.S. – CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx – control a significant portion of the prescription drug market. These companies work on behalf of employers and government health programs to negotiate drug prices, manage payments to pharmacies, and determine patient access to medications.
While benefit managers are intended to lower costs for all parties involved, critics argue that the industry’s consolidation and increased control over drug distribution have actually contributed to rising drug prices. The report highlights the need for increased oversight and potential regulatory measures to address these concerns.
In conclusion, the F.T.C.’s report sheds light on the practices of pharmacy benefit managers and calls for closer scrutiny of their operations. It remains to be seen how this will impact the industry moving forward, but it is clear that the landscape of prescription drug pricing may be subject to significant changes in the near future.
