New FTC Investigation Report Targets PBMs
In its initial report on an antitrust investigation into the role of pharmacy benefits managers (PBMs), the competitiveness watchdog Federal Trade Commission (FTC) says PBMs have vast power that disadvantages consumers and independent pharmacies. It reports the following:
- Consolidation and vertical integration of health plans and PBMs have impacted price and accessibility and led to anti-competitive behavior.
- Independent pharmacies suffer broadly from the trends in the PBM industry.
- It criticized narrow and preferred network strategies, formulary and rebate arrangements, and specialty pharmacy arrangements.
- It noted that 80% of all PBM business is controlled by just three major entities – United’s Optum, CVS’ Caremark, and Cigna’s Express Scripts.
- Arrangements with owned entities, including retail pharmacies, mail-order pharmacies, and specialty pharmacies, hurt consumers.
The major PBM lobbying group pushed back on the findings vigorously. While PBMs need reform and more transparent approaches, I feel the FTC has put the entire onus for high prices and anti-competitive behavior on PBMs and not brand drug makers. The FTC has adopted the same whipping boy mentality as Congress.
Additional articles: https://www.fiercehealthcare.com/payers/ftc-report-pbms-may-urgently-require-potential-regulation and https://www.modernhealthcare.com/politics-policy/pharmacy-benefit-managers-pbms-higher-prices-ftc-cvs-cigna-unitehealth and https://thehill.com/policy/healthcare/4762024-federal-trade-commission-report-pharmacy-middlemen-price-hikes/
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#pbms #drugpricing
https://www.healthcaredive.com/news/ftc-pharmacy-benefit-manager-investigation-interim-report/720814
