The Federal Trade Commission (FTC) has filed a lawsuit against three major pharmacy benefit managers (PBMs) – Optum Rx, Caremark, and Express Scripts – alleging that they artificially inflate insulin prices to boost profits.
The Federal Trade Commission on Friday sued three large U.S. health companies that negotiate insulin prices, arguing the drug middlemen boost their profits while 'artificially' inflating costs for patients. The suit targets the three biggest so-called pharmacy benefit managers , UnitedHealth Group's Optum Rx, CVS Health's Caremark and Cigna's Express Scripts, and their affiliated group purchasing organizations.
The FTC may also recommend suing insulin manufacturers Eli Lilly, Sanofi and Novo Nordisk in the future.Express Scripts. All are owned by or connected to health insurers and collectively administer about 80% of the nation's prescriptions, according to the FTC. The FTC's lawsuit also includes each PBM's affiliated group purchasing organization, which brokers drug purchases for hospitals and other health-care providers. The agency said it could recommend suing drugmakersA UnitedHealth spokesperson said the suit 'demonstrates a profound misunderstanding of how drug pricing works,' noting that Optum RX has 'aggressively and successfully' negotiated with drug manufacturers. A CVS spokesperson said Caremark is 'proud of the work' it has done to make insulin more affordable for Americans, adding that 'to suggest anything else, as the FTC did today, is simply wrong.' And, a spokesperson for Express Scripts said the suit 'continues a troubling pattern from the FTC of unsubstantiated and ideologically-driven attacks' on PBMs. It comes three days after Express Scripts sued the FTC, demanding that the agency retract its allegedly 'defamatory' statements.PBMs sit at the center of the drug supply chain in the U.S. They negotiate rebates with drug manufacturers on behalf of insurers, large employers and federal health plans. They also create lists of medications, or formularies, that are covered by insurance and reimburse pharmacies for prescriptions
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