The Federal Trade Commission said Friday that it is suing three drug middlemen, accusing them of inflating insulin prices.
The FTC accused the "Big Three" pharmacy benefit managers (PBMs) — UnitedHealth Group's Optum Rx, CVS Health's Caremark and Cigna's Express Scripts — of "engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs, impaired patients’ access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients." Around 8 million Americans rely on insulin in the U.S., per the FTC.
PBMs work with insurance companies to negotiate discounted prices from drug companies in exchange for including the drugs in their coverage. In theory, they are supposed to save patients money.
Also included in the lawsuit are the PBMs' group purchasing organizations, which include Zinc Health Services, Ascent Health Services and Emisar Pharma Services.
The "Big Three" 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.
"This perverse system results in billions of dollars in rebates and fees for the PBMs and their health plan sponsor clients — but does so at the expense of certain vulnerable diabetic patients who must pay significantly more out-of-pocket for their critical medications," the FTC said in a news release.
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