FTC Sues Major Pharmacy Benefit Managers for Inflating Insulin Prices

On September 20, 2024, the Federal Trade Commission (FTC) said it is suing three large companies that help decide how much people pay for insulin, a medicine that helps millions of Americans with diabetes.

These companies, called pharmacy benefit managers (PBMs), are Optum Rx, Caremark, and Express Scripts. The FTC says these companies have made insulin more expensive than it should be.

Here’s how it works: PBMs are supposed to help patients by negotiating discounts with drug companies, which should lower the price of medicines like insulin. But the FTC says these companies created a system that actually makes insulin more expensive, causing some people to pay more, even though they need the drug to stay healthy.

Around 8 million people in the U.S. rely on insulin, and many are now paying high prices because of this system. The FTC argues that instead of helping patients save money, the PBMs have been focused on getting money back (rebates) from drug companies, which raises insulin prices.

Caremark, one of the companies, disagrees and says they’ve worked to keep prices low. They say their customers pay less than $25 for insulin, thanks to a special program they have.

Another company, Cigna, thinks the FTC’s lawsuit is wrong and says it could make drug prices even worse.

The FTC hopes to fix the problem by stopping these practices, but the companies argue they’re being unfairly targeted.