The Federal Trade Commission is preparing to sue UnitedHealth Group, CVS Health and the Cigna Group over their pharmaceutical benefit managers' business practices, The Wall Street Journal reported July 10.
The FTC published a report on July 9 alleging PBMs favor their own pharmacies and "wield enormous power" over the types of drugs patients can access and the prices they pay.
UnitedHealth Group's OptumRx, Cigna's Express Scripts and CVS' Caremark handle 79% of prescriptions in the U.S., according to the FTC report.
Sources familiar with the lawsuit told the Journal the FTC is preparing to file a challenge related to rebates PBMs negotiate with drug manufacturers. The commission is also investigating drug manufacturers' role in the negotiations, one source told the Journal.
Spokespeople for CVS Caremark and Express Scripts said PBMs have reduced costs for employers and patients.
"CVS Caremark is proud of the work we have done to make insulin more affordable for all Americans with diabetes, and we stand by our record of protecting American businesses, unions and patients from rising prescription-drug prices," a spokesperson told the Journal.
"We work to combat the pharmaceutical industry’s high prices and lower the cost of thousands of medicines for patients and their health plans, and the data shows that we succeed," an Express Scripts spokesperson said.
OptumRx declined to comment to the Journal, but called the FTC's report "incomplete" and "flawed" in a previous statement.
FTC Chair Lina Khan said the report shows PBMs are hiking the costs of drugs for patients and can squeeze smaller pharmacies out of business.
"The FTC will continue to use all our tools and authorities to scrutinize dominant players across healthcare markets and ensure that Americans can access affordable healthcare," Ms. Khan said July 9.
One FTC commissioner, Melissa Holyoak, dissented against the report findings, criticizing the report for process irregularities and a lack of substance.