- The U.S. Federal Trade Commission (FTC) has highlighted concerns over the consolidation of pharmacies and health insurance companies, which has empowered a small number of pharmacy benefit managers (PBMs) to wield significant influence over prescription drug prices. PBMs act as intermediaries between drug manufacturers and consumers, negotiating discounts and managing which medications are covered by insurance plans. The FTC’s interim report underscores that the three largest PBMs—UnitedHealth Group’s Optum, CVS Health’s CVS Caremark, and Cigna’s Express Scripts—control a substantial majority of U.S. prescription drug claims, potentially enriching themselves at the expense of smaller pharmacies and consumers. The report calls for heightened regulation amid allegations that PBMs inflate drug costs and limit competition, ultimately impacting affordability and access to medications for Americans. (Articles here, here, and here)
July 17, 2024
Payers | Tea Leaves