
For the second time in less than a year, the Federal Trade Commission released a highly critical report of pharmacy benefit managers, which play a crucial but opaque role in the pharmaceutical supply chain. And the findings may provide further impetus for legislative action to curb practices that critics say contribute to the rising cost of prescription drugs.
The latest report accuses the PBMs — CVS Caremark, Optum Rx, and Express Scripts, all of which are owned by large health insurers — of boosting prices of specialty generic drugs that are sold through their own pharmacies. By doing so, the companies significantly padded their bottom lines at the expense of the American health care system, according to the FTC.
Specifically, the companies were able to generate more than $7.3 billion in revenue by dispensing medicines to treat cancer, HIV, heart disease, and other serious illnesses at prices that exceeded their estimated acquisition costs between 2017 and 2022. The FTC noted in its report that so-called specialty generic drugs represent a large and growing amount of spending by plan sponsors and patients.

This article is exclusive to STAT+ subscribers
Unlock this article — plus in-depth analysis, newsletters, premium events, and news alerts.
Already have an account? Log in