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CVS Health reaches proposed settlement with FTC on insulin pricing

FTC reached a settlement with Express Scripts in February and is currently in negotiations with OptumRx.
By Susan Morse , Executive Editor
CVS pharmacy

Photo: Mario Tama/Getty Images

The Federal Trade Commission and CVS Health have reached a proposed settlement over insulin pricing.

On March 23, the FTC filed a joint motion to withdraw the matter with respect to Caremark and the proposed consent agreement.

No details of the proposed settlement were released. CVS said the final terms were still pending and the settlement would be confirmed once the terms were finalized, according to Reuters.

The terms are expected to be similar to the settlement reached between the FTC and Express Scripts in February. In what the FTC called a "landmark settlement," the terms required Express Scripts to make fundamental changes to its business practices.

Express Scripts is part of Evernorth Health Services, the health services division of The Cigna Group.

The settlement requires that Express Scripts and its affiliated entities adopt changes to their business practices that increase transparency and drive down patients' out-of-pocket costs for drugs like insulin by up to $7 billion over 10 years. 

The pharmacy benefit manager is also required to bring millions of dollars in new revenue to community pharmacies each year and to provide covered access to TrumpRx as part of its standard offering.

The FTC brought the case against the PBMs claiming prices were artificially inflated through "anticompetitive and unfair rebating practices." Regulators have said the PBM model incentivizes companies to introduce higher list prices and steer customers to more expensive drugs, driving larger discounts.

The settlements resolve these claims, the FTC said.

FTC reached a settlement with Express Scripts in February and is currently in negotiations with OptumRx.

The case of the United States of America before the Federal Trade Commission is against pharmacy benefit managers Caremark Rx, Express Scripts, Evernorth and OptumRx, as well as group purchasing organizations Zinc Health Services, Medco Health Services, Ascent Health Services and Emisar Pharma Services.

 

 

Email the writer: SMorse@himss.org