FTC says prescription middlemen are squeezing Main Street pharmacies

Source: CBS News

July 9, 2024 / 4:16 PM EDT


Prescription drug middlemen — also known as pharmacy benefit managers — are lining their pockets by inflating drug prices, including overcharging cancer patients, the Federal Trade Commission said Tuesday.

"The FTC's interim report lays out how dominant pharmacy benefit managers can hike the cost of drugs — including overcharging patients for cancer drugs," FTC Chair Lina M. Khan said in a news release. "The report also details how PBMs can squeeze independent pharmacies that many Americans — especially those in rural communities — depend on for essential care."

Pharmacy Benefit Managers began, decades ago, as administrators, validating and processing pharmacy benefits provided by separate insurance plans. After years of acquisitions, that's no longer the case, as the FTC lays out in its report. PBMs now serve as vertically integrated health plans and pharmacists, wielding enormous control over the availability and cost of drugs by negotiating the terms and conditions for access to prescription medications for hundreds of million of Americans.

The three largest PBMs — CVS Caremark, Express Scripts and OptumRX — now manage almost 80% of all prescriptions filled in this country, the FTC noted. If the next three largest — Humana Pharmacy Solutions, MedImpact and Prime — are included, the six will oversee 94% of prescription drug claims in the U.S.

Read more: https://www.cbsnews.com/news/ftc-pbm-investigation/