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FTC to Investigate CVS Caremark, Humana And Other Pharmacy Benefits

The FTC is conducting a fresh inquiry into the prescription medication middlemen sector and pharmacy benefit managers. Pharmacy benefit managers are employed to work with medication manufacturers to negotiate rebates and fees, develop drug formularies and regulations, and reimburse pharmacies for their patients’ prescriptions.

According to the FTC, certain pharmacy benefit managers have “enormous control” over which prescriptions are provided to patients, which pharmacies they may use, and how much they spend at the pharmacy counter. The government will ask the six major pharmacy benefit managers for data and other information regarding their business operations. CVS Caremark, Cigna’s Express Scripts Inc., UnitedHealth Group’s OptumRx Inc., Humana Inc., Prime Therapeutics LLC, and MedImpact Healthcare Systems Inc. are among them.

Medication manufacturer price-setting is the core source of excessive drug expenditures,” the Pharmaceutical Care Management Association (PCMA), a trade association representing pharmacy benefit managers, told FOX Business.

PCMA President and CEO JC Scott stated, “The most effective research of concerns surrounding medicine pricing for consumers would investigate the whole supply chain.” PBMs keep drug firms responsible by negotiating the lowest feasible price on behalf of customers and generating and delivering the local competition that customers desire. CVS Caremark, Humana, and Prime Therapeutics representatives told FOX Business that they will comply with the FTC probe. OptumRx consulted the PCMA. FOX Business reached out to the other firms for comment, but they did not respond.

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