FTC Activity

October 8, 2024

EGWP marketplace medicaid Medicare

On Sept. 20, the Federal Trade Commission (FTC) filed a complaint against PBMs claiming negotiated rebates are an “unfair method of competition” and have inflated insulin list prices, despite the FTC acknowledging net insulin prices have declined over time and that PBMs pass rebates to plan sponsors. The Democratic commissioners voted 3-0 to approve the complaint with the two Republican commissioners recusing themselves.

In response to the FTC’s reckless action, Express Scripts issued a statement saying, “the fact is that in the unlikely event the FTC succeeds in its suit and forces PBMs to include drugs on formulary even if they have higher net costs for plan sponsors – and regardless of whether they are clinically necessary – the FTC will drive drug prices higher in this country.”

Separately, Express Scripts filed a lawsuit against the FTC on Sept. 17 demanding a withdrawal of the July 2024 Interim Staff Report on PBMs. In a detailed filing, Express Scripts outlines the millions of documents and terabytes of data that have been disregarded by the FTC and how the resulting report includes false statements, misleading insinuations, and violates the Commission’s duty to follow due process and serve the public interest. Information about Express Scripts’ lawsuit to protect those it serves is available here.

legislation

House Judiciary Subcommittee Holds Hearing on the Role of PBMs

On Sept. 11, the House Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust held a hearing titled, “The Role of Pharmacy Benefit Managers,” featuring academic witnesses. The hearing focused on transparency, affordability, and access, as well as the relationship between PBMs and independent pharmacies. Witnesses highlighted the critical role of PBMs in the […]
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October 8, 2024

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Initiatives

House Education and the Workforce Committee Holds Hearing in Honor of ERISA 50th Anniversary

On Sept. 10, the House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions held a hearing titled, “ERISA’s 50th Anniversary: The Value of Employer-Sponsored Health Benefits.” Policy experts and advocates representing large employers, small business owners, and consumers discussed potential ways to strengthen the Employee Retirement Income Security Act (ERISA) and employer-sponsored coverage. […]
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October 8, 2024

EGWP Medicare

legislation

Alaska Governor Approves PBM Regulation

After delaying a decision for several months, Alaska Gov. Mike Dunleavy (R) signed HB 226, an anti-PBM bill that passed by the legislature earlier this year. The bill contains problematic language that could ultimately raise costs and reduce choice for employers and consumers. Those provisions include restrictions on the use of white bagging and home […]
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October 8, 2024

EGWP marketplace medicaid Medicare

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