The Federal Trade Commission said Friday that it is suing three drug middlemen, accusing them of inflating insulin prices.<\/p>\n
The FTC accused the \u2018Big Three\u2019 pharmacy benefit managers (PBMs) \u2014 UnitedHealth Group\u2019s Optum Rx, CVS Health\u2019s Caremark and Cigna\u2019s Express Scripts \u2014 of \u2018engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs, impaired patients\u2019 access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients.\u2019 Around 8 million Americans rely on insulin in the U.S., per the FTC.<\/p>\n
PBMs work with insurance companies to negotiate discounted prices from drug companies in exchange for including the drugs in their coverage.\u00a0In theory, they are supposed to save patients money.<\/p>\n
Also included in the lawsuit are the PBMs\u2019 group purchasing organizations, which include Zinc Health Services, Ascent Health Services and Emisar Pharma Services. <\/p>\n
The \u2018Big Three\u2019 oversee around 80% of all prescription drug plans in the U.S., according to the complaint, which alleges that they created a rebate system prioritizing high rebates from drug manufacturers, which led to the inflated insulin prices. <\/p>\n
\u2018This perverse system results in billions of dollars in rebates and fees for the PBMs and their health plan sponsor clients \u2014 but does so at the expense of certain vulnerable diabetic patients who must pay significantly more out-of-pocket for their critical medications,\u2019 the FTC said in a news release.<\/p>\n
In a statement, CVS Caremark said the FTC\u2019s allegations are \u2018simply wrong\u2019 and blamed drug manufacturers for hiking up the price of the drugs.<\/p>\n
\u2018CVS Caremark has led the way in driving down the cost of insulin for all patients: insured, uninsured, and underinsured,\u2019 the company said. \u2018Our members on average pay less than $25, far below list prices and far below the Biden Administration\u2019s $35 cap. Further, we also provide access to $25 insulin to every American, whether insured or uninsured, through our ReducedRx program at every one of our 67,000 network pharmacies and more than 9,000 CVS pharmacies.\u2019<\/p>\n
Cigna\u2019s Chief Legal Officer, Andrea Nelson, said the FTC\u2019s lawsuit continues its \u2018troubling pattern\u2019 of \u2018unsubstantiated and ideologically driven attacks on pharmacy benefit managers,\u2019 including a report the commission released in July accusing the PBMs of hiking up the drug prices. Cigna filed a lawsuit against the FTC on Tuesday requesting that they withdraw the report.<\/p>\n
\u2018Once again, the FTC \u2014 a government agency funded by taxpayer dollars \u2014 is proving that the FTC does not understand drug pricing and instead is choosing to ignore the facts and score political points, rather than focus on its duty to protect consumers,\u2019 Nelson said in a statement. \u2018The fact is that in the unlikely event the FTC succeeds in its suit and forces PBMs to include drugs on formulary even if they have higher net costs for plan sponsors \u2014 and regardless of whether they are clinically necessary \u2014 the FTC will drive drug prices higher in this country. This will hurt consumers and those who provide their prescription drug benefits \u2014 including employers, labor unions, and the federal government itself.\u2019<\/p>\n
UnitedHealth Group did not immediately respond to requests for comment. <\/p>\n
The FTC said that insulin medication was previously more affordable, using the example of Humalog, a medication manufactured by Eli Lilly, that cost about $21 in 1999. The drug was priced at $274 in 2017, as a result of the PBMs rebate system strategy, the FTC said.<\/p>\n
\u2018Millions of Americans with diabetes need insulin to survive, yet for many of these vulnerable patients, their insulin drug costs have skyrocketed over the past decade thanks in part to powerful PBMs and their greed,\u2019 said Rahul Rao, the deputy director of the FTC\u2019s Bureau of Competition.<\/p>\n
It\u2019s not only the PBMs that are responsible for the skyrocketing prices, the FTC said, but also drug manufacturers like Eli Lilly and Novo Nordisk, which the commission says \u201cshould be on notice\u201d because they may be sued in the future.<\/p>\n
In a statement, White House Press Secretary Karine Jean-Pierre said they do not have any comment on the lawsuit, but \u2018have made clear that no one should pay higher prices because of corporate greed.\u2019<\/p>\n
\u2018The President and Vice President\u00a0have been\u00a0taking on profiteering by Big Pharma and\u00a0pharmaceutical middle-men\u00a0to lower the costs of healthcare and prescription drugs\u2014from giving Medicare the power to negotiate lower drug prices,\u00a0to lowering prices for insulin, inhalers, EpiPens and hearing aids by increasing competition,\u2019 Jean-Pierre said.\u00a0<\/p>\n
National Community Pharmacists Association supported the FTC\u2019s lawsuit against the PBMs in a statement released Friday. <\/p>\n
\u2018One of the many ways that PBMs manipulate the system against patients, taxpayers, and small pharmacies is the rebate game,\u2019 said B. Douglas Hoey, the association\u2019s chief executive officer. \u2018The PBMs determine which drugs are covered by health insurance plans. They get bigger rebates for the most expensive drugs. Naturally, the most expensive drugs end up on the formularies even when there are cheaper alternatives. Patients end up paying more. Employers end up paying more. Taxpayers end up paying more. And more small business pharmacies are driven out of business. The rebates create a powerful incentive for higher drug prices, which is completely upside-down.\u2019<\/p>\n
In July, Democratic and Republican lawmakers blamed executives from Caremark, Express Scripts and Optum Rx\u00a0for sky-high prescription drug prices in the U.S. during an oversight committee hearing.<\/p>\n
\u201cOn one hand we have PBMs claiming to reduce prescription drug prices, and on the other hand we have the Federal Trade Commission, we have major media outlets like The New York Times and we have at least eight different attorneys generals, Democrats and Republicans, who all say PBMs are inflating drug costs,\u201d Rep. Raja Krishnamoorthi, D-Ill., said.\u00a0<\/p>\n
The committee\u00a0launched an investigation in March 2023 into PBMs\u2019 role in the rise in health care costs. The lawsuit also comes as states \u2014 most recently Vermont \u2014 have sued PBMs, alleging they drive up drug costs.<\/p>\n<\/p>\n
The Federal Trade Commission said Friday that it is suing three drug middlemen, accusing them of inflating insulin prices. The FTC accused the \u2018Big Three\u2019 pharmacy benefit managers (PBMs) \u2014 UnitedHealth Group\u2019s Optum Rx, CVS Health\u2019s Caremark and Cigna\u2019s Express Scripts \u2014 of \u2018engaging in anticompetitive and unfair rebating practices that have artificially inflated the […]<\/p>\n","protected":false},"author":0,"featured_media":9986,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-9985","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-business"],"_links":{"self":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts\/9985","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/comments?post=9985"}],"version-history":[{"count":0,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/posts\/9985\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/media\/9986"}],"wp:attachment":[{"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/media?parent=9985"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/categories?post=9985"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstriumphs.com\/index.php\/wp-json\/wp\/v2\/tags?post=9985"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}