New FTC commissioner could turn the tide for an investigation into PBMs
The Senate last week voted along party lines, 51-50, with Vice President Kamala Harris casting the tie-breaker, to make President Biden appointee Alvaro Bedoya the deciding vote on a split 2-2 Federal Trade Commission.
The addition of Bedoya to the FTC could not only spell more trouble for biopharma M&A activity, as he may align with his Democrat partners to break the FTC ties, but it may also mean that FTC Chair Lina Khan has what she needs to move forward on a study around the pharma middlemen known as pharmacy benefit managers.
The FTC was previously deadlocked, with a 2-2 vote from last February, regarding the need for such a study (meaning it did not move forward), although many in and around the pharmacy world raised concerns at that meeting.
National Community Pharmacists Association CEO B. Douglas Hoey praised Bedoya’s confirmation in a statement, adding, “We believe that he shares the commitment to investigating pharmacy benefit managers and empowering consumer choice by preserving small business competition.”
The top three PBMs — CVS Caremark, Express Scripts and OptumRX — control 80% of the PBM market, include three of the four largest US pharmacies by prescription drug revenue, and are either owned by or own insurance companies.
A closer look into some of these PBM pricing games shows how they can control markets, and use anti-competitive tactics, like favoring brand-name drugs when generics are available, to boost their own bottom lines.
But it remains unknown if Khan will push forward with her current plan for a PBM study, with just the three Democrat votes, or try to win over the two other FTC commissioners with a new PBM study plan.
Previously, FTC commissioners Noah Phillips and Christine Wilson, who voted against conducting the FTC study on PBMs but remained open to such a study, claimed that that current plan under Khan to study PBMs was not designed to investigate their competitive effects, and it’s not clear this study would reveal anything about patients’ out-of-pocket costs.
Prior to joining the FTC, Bedoya was the founding director of the Center on Privacy & Technology at Georgetown University Law Center, where he is currently a visiting professor of law.
According to the FTC, he has been influential in research and policy in the areas of privacy and technology. He previously served as chief counsel to the Senate Judiciary subcommittee on Privacy, Technology and the Law, and Counsel and as chief counsel to former Sen. Al Franken (D-MN).