An ongoing Federal Trade Commission study finds pharmacy benefit managers may have inflated drug costs while squeezing independent pharmacies, enriching some of the largest companies in the country at the expense of patients.
The interim FTC report released Tuesday details the market influence of companies known as PBMs, which are hired and, in many cases, owned by health insurers to manage drug benefits within heath plans. Their roles include negotiating prices, setting co-pays for medications and creating pharmacy networks where patients can fill prescriptions.
Eagan-based Prime Therapeutics and OptumRx, a division of Minnetonka-based UnitedHealth Group, were two of six PBMs singled out in the report.
“The FTC’s interim report lays out how dominant pharmacy benefit managers can hike the cost of drugs — including overcharging patients for cancer drugs,” FTC Chair Lina Khan said in a statement. “The report also details how PBMs can squeeze independent pharmacies that many Americans — especially those in rural communities — depend on for essential care.”
The trade group for PBMs decried the report, saying it “falls far short of being a definitive, fact-based assessment” and didn’t live up to FTC’s history of objectivity.
The Pharmaceutical Care Management Association noted in a statement that one member of the five-person commission disagreed with the decision to release the report. It was based on anecdotes, anonymous comments and “cherry-picked case studies,” according to the trade group.
“Throughout this process, FTC leadership has shown that they have predetermined conclusions that they want to advance irrespective of the facts or the data, and this report demonstrates an intention to follow through on their agenda regardless of the evidence,” the association said in a statement. “Nothing can change the fact that PBMs are operating in an extremely competitive market and have a proven track record of reducing prescription drug costs.”
Interim studies are unusual and do not represent a final report from the FTC, Commissioner Andrew Ferguson wrote Tuesday in a statement. The final version, Ferguson said, should include more definitive evidence of pharmacy-reimbursement practices and incentives, but he concluded: “It is important for the commission to share what staff has learned to date, such as it is.”