A recent interim report by the Federal Trade Commission revealed that pharmacy benefit managers (PBMs) have generated $7.3 billion in revenue by inflating the prices of specialty generic drugs between 2017 and 2022. PBMs act as intermediaries between drug manufacturers, insurers, and pharmacies, and the three largest PBMs in the nation - CVS Health's Caremark, Cigna's Express Scripts, and UnitedHealth Group's Optum Rx - were found to have marked up drug prices significantly.
The FTC's investigation highlighted that PBMs reimbursed their affiliated pharmacies at higher rates than unaffiliated pharmacies for 51 specialty generic drugs, including medications for heart disease, cancer, and HIV. This practice resulted in patients, employers, insurers, and others paying inflated prices for essential medications.
