The FTC alleges that CVS’s Caremark, Cigna’s Express Scripts, and UnitedHealth’s Optum Rx engaged in illegal rebate programs that inflated insulin prices significantly. These drug middlemen accepted payments from manufacturers to favor higher-priced insulin options, pushing costs onto consumers while they profited from increased rebate revenues.
The complaint indicates a deepening conflict between the FTC and major pharmacy benefit managers (PBMs) that currently control around 80% of US prescription volumes. These companies have been scrutinized for their roles in manipulating drug pricing structures.
Despite the absence of public documents, the FTC outlined that the administrative complaint would initiate a formal hearing process. The agency expresses its intent to challenge unfair competition from PBMs to achieve lower insulin prices for consumers.
Historical price data cited by the FTC shows that the list price of Humalog insulin skyrocketed by 1,200% from 1999 to 2017, highlighting the significant impact of PBMs in the marketplace as they prioritize financial gains from rebates over consumer affordability.
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