FTC to Study Pharmacy Benefit Manager Practices

By Kathryn Hardison

The Federal Trade Commission on Tuesday said it will launch an inquiry into the prescription drug middleman industry to weigh the impact that vertically-integrated pharmacy benefit managers have on the accessibility and affordability of prescription drugs.

The FTC said it is requiring the six largest pharmacy benefit managers, which negotiate rebates and fees with drug manufacturers, provide records and information related to their business practices. The compulsory orders are being sent to CVS Caremark, Express Scripts Inc., OptumRx Inc., Humana Inc., Prime Therapeutics LLC and MedImpact Healthcare Systems Inc., the FTC said

Pharmacy benefit managers also reimburse pharmacies for patients' prescriptions and create drug formularies--a list of prescription drugs that are paid for by a health plan--and other policies, the FTC said. The largest pharmacy benefit managers are vertically-integrated with health insurance companies and wholly-owned mail order and specialty pharmacies, which the FTC said gives the managers a large influence on what patients pay for their prescriptions and where they purchase them.

"Although many people have never heard of pharmacy benefit managers, these powerful middlemen have enormous influence over the U.S. prescription drug system," FTC Chairwoman Lina Khan said. "This study will shine a light on these companies' practices and their impact on pharmacies, payers, doctors, and patients."

The inquiry will also look into the use of specialty drug lists and related specialty drug policies. The FTC said it has received more than 24,000 public comments about pharmacy benefit managers.

Write to Kathryn Hardison at [e-mail]

(END) Dow Jones Newswires

June 07, 2022 14:13 ET (18:13 GMT)

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