FTC releases second report on PBM price hikes of specialty drugs

Key Points

  • The FTC released a report accusing the three largest PBMs of hiking specialty drug prices by thousands of percent, generating $7.3 billion in revenue from 2017 to 2022.
  • The PBMs involved are UnitedHealth Group's Optum RX, CVS's Caremark, and Cigna's Express Scripts.
  • FTC Chair Lina Khan emphasized the need for continued investigation and swift action against any illegal conduct by PBMs.
  • The report highlights that these price hikes are particularly burdensome for commercial plans, with higher markups on specialty generic drugs.
  • The practices contribute to higher profits for the companies owning these PBMs, impacting independent pharmacies negatively.

Summary

The Federal Trade Commission (FTC) has issued a report criticizing the three largest pharmacy benefit managers (PBMs) - Optum RX, Caremark, and Express Scripts - for significantly increasing the prices of specialty drugs, leading to a collective revenue of $7.3 billion over five years. The report, the second of its kind, accuses these PBMs of contributing to higher healthcare costs through their market dominance. FTC Chair Lina Khan has called for further investigation into these practices, highlighting the urgent need for legislative action due to the alarming rate at which these price hikes are growing. The report notes that these markups are especially high for commercial plans, with some employers possibly unaware of the extent of these costs. The practices not only inflate profits for the companies but also put financial pressure on independent pharmacies, which struggle with low reimbursement rates. The FTC suggests that these practices might violate laws and encourages legislative reforms to address these issues.

yahoo
January 14, 2025
Stocks
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