Thread by @FTC

#BREAKING: @FTC launches inquiry into prescription drug middlemen industry. Agency to scrutinize impact of vertically integrated Pharmacy Benefit Managers on the access and affordability of medicine: bit.ly/3mlNH1J #PBMs /1

FTC will launch an inquiry into the prescription drug middleman industry, requiring the 6 largest #PBMs to provide information and records regarding their business practices. /2

Agency will send compulsory orders to CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc.; Prime Therapeutics LLC; and MedImpact Healthcare Systems, Inc. #PBMs /3

Inquiry aimed at shedding light on several practices that have drawn scrutiny in recent years including:
• fees and clawbacks charged to unaffiliated pharmacies
• methods to steer patients towards #PBM-owned pharmacies
• potentially unfair audits of independent pharmacies /4

Other practices including:
• complicated and opaque methods to determine pharmacy reimbursement
• prevalence of prior authorizations and other administrative restrictions
• use of specialty drug lists and surrounding specialty drug policies

#PBMs /5

…and impact of rebates and fees from drug manufacturers on formulary design and the costs of prescription drugs to payers and patients #PBMs /6

Inquiry will build on the significant public record developed in response to the request for information about pharmacy benefits managers that the agency launched on 2/24/22 which resulted in 24,000 public comments to date #PBMs /7

FTC is issuing the orders under Section 6(b) of the FTC Act, which authorizes the Commission to conduct studies without a specific law enforcement purpose. Companies will have 90 days from the date they receive the order to respond #PBMs /8

PBM model order: bit.ly/3NrD7Cj #PBMs /9