FTC Report Highlights PBMs' Influence on U.S. Drug Prices

Pharmacy benefit managers (PBMs) control 79% of U.S. drug claims. They negotiate drug prices, decide insurance coverage, and pay pharmacies. The FTC says these middlemen inflate costs and hurt smaller pharmacies.

PBMs like Optum, CVS Caremark, and Express Scripts dominate. They often favor their own businesses, disadvantaging independents. Contracts with these PBMs can be unfair, unclear on final payments.

The FTC found PBMs negotiate rebates to limit cheaper generic drugs. This investigation started in 2022, expanded to six major PBMs. The FTC plans more scrutiny, possible regulation.

PBMs are key in drug pricing. They act between drug makers and consumers. Their power grows from market consolidation, deals between pharmacies and insurers. This gives them control over drug prices and access.

The FTC's report highlights lack of transparency. PBMs set drug coverage and prices without public accountability. This affects what drugs are available and at what cost.

The FTC's findings support more regulation. They aim to protect consumers and smaller pharmacies from PBM dominance. The investigation continues, focusing on dominant healthcare players.