FTC wants to know: How are PBMs affecting drug affordability and access?
Following the Federal Trade Commission’s decision to not, at least initially, dig deeper into pharma middlemen known as PBMs, the commission is now seeking comments on ways that these massive, vertically integrated PBMs are affecting drug affordability and access.
PBMs — led by the big 3 of UnitedHealth’s OptumRx, CVS Caremark, and Cigna’s Express Scripts controlling almost 80% of the market — generally make their money by managing prescription drug benefits on behalf of private health insurers, Medicare Part D drug plans, large employers, and other payers. But the PBMs also figure out ways to tilt the market in their favor, as the FTC noted how the largest PBMs are vertically integrated with health insurance companies and specialty pharmacies, “giving them financial incentives to steer patients to use their affiliated services.”
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