Large companies that spend billions of dollar a year on prescription drugs for their employees are hoping that the Federal Trade Commission’s inquiry into pharmaceutical benefit manager business practices will yield information that spurs major policy changes to reduce drug prices.
“PBMs were originally created to be a solution to high drug costs, but now we see them as part of the problem,” Bill Kramer, executive director for health policy with the Purchaser Business Group on Health, said in an interview.
The FTC unanimously voted June 7 to conduct an inquiry into the PBM industry, sending compulsory orders to the six largest PBMs—CVS Caremark, Express Scripts Inc., OptumRx Inc., Humana Inc., Prime Therapeutics LLC, and MedImpact Healthcare Systems Inc.— to provide a wide range of information concerning the competitive impact of their contracting and business practices within 90 days.
No date was set for issuing a special report from the information gathered.
PBMs negotiate drug discounts for health plans, and they typically devise formularies that stipulate whether particular drugs are covered and how much enrollees will have to pay for a drug. They have come under criticism for opaque business practices that may obscure whether employers are getting the best prices and the highest-value drugs.
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