PBMs “Have Not Fully Compiled” with Antitrust Inquiry, FTC Says

By Consumers for Quality Care, on March 27, 2024

Federal Trade Commission (FTC) Chairperson Lina Khan recently offered heavy criticism of pharmacy benefit managers (PBMs), accusing them of failing to fully cooperate with the agency’s probe into potentially anti-competitive practices, according to the Ohio Capital Journal.

“The PBMs have not fully complied with our orders to turn over documents and data. FTC orders are not suggestions and we will not hesitate to use the full extent of our legal authorities to mandate compliance,” said Chairperson Khan during a recent White House roundtable event discussing a range of concerns within in our country’s health care system.

These latest comments about PBMs come at a time of increased scrutiny of their business practices. The three largest PBMs – Optum, Express Scripts, and CVS Caremark – are owned by some of the largest corporations in the country and control more than 80 percent of the prescription drug marketplace.

PBMs were created originally to enhance the purchasing power of employer-based health plans. But owing to a lack of transparency in the industry, it’s unclear whether PMBs create any savings from negotiated deals with pharmaceutical companies, and if so, whether any of the savings are passed on to consumers. The concerns is that PBMs serve as mere middlemen, setting prices between prescription drug manufacturers, health plans, and pharmacies, and holding significant sway over what consumers pay for a medication.

Chairperson Khan expressed concern over the number of independent pharmacies across the country that are shutting their doors because of the anti-consumer practices of PBMs. “Few small businesses are as essential to communities as independent pharmacies — especially in rural America. But independent pharmacies tell us they’re being squeezed and forced out of business due to coercive contracts and punishing fees imposed by the PBMs,” said Khan.

CQC urges lawmakers and regulators to scrutinize PBM practices that are driving up the cost of prescription medications for consumers.