The Federal Trade Commission’s legal action against the three largest pharmacy benefit managers is on hold.
The agency has temporarily stopped its in-house case against CVS Health’s CVS Caremark, Cigna’s Express Scripts and UnitedHealth Group’s OptumRx, as well as their group purchasing organizations, Zinc Health Services, Ascent Health Services and Emisar Pharma Services. The case alleges the companies deployed rebate schemes that wrongly inflated insulin prices.
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FTC General Counsel Lucas Croslow filed an order Tuesday pausing the administrative court proceeding since there are currently no sitting commissioners participating in the matter. Last month, President Donald Trump fired Democratic commissioners Rebecca Kelly Slaughter and Alvaro Bedoya, who were the only two members participating in the PBM action. Slaughter and Bedoya are suing the presidential administration and demanding it reinstates their positions.
Last September, Chair Andrew Ferguson and Commissioner Melissa Holyoak, both Republicans, recused themselves, while former FTC Chair Lina Khan, Slaughter and Bedoya voted in favor of filing the administrative complaint. Khan resigned from the agency in January.
The pause will remain in effect for at least 105 days, and an evidentiary hearing date will be scheduled 225 days after the stay is lifted, the order says.
CVS Health, Cigna and UnitedHealth Group have denied the FTC's allegations and have attempted to have the case dismissed.
The FTC has also released reports over the past year that found the leading PBMs pay higher prices to their affiliated pharmacies and wrongly inflated costs for specialty generic drugs. CVS Caremark, Express Scripts and OptumRx, which have said the reports are misleading, control nearly 60% of the pharmacy benefits market based on rebate negotiations, retail network management and claims adjudication, according to the American Medical Association.
