PBMs not complying with federal probe: FTC

In June 2022, the Federal Trade Commission launched a probe into the business practices of pharmacy benefit managers and how they affect drug affordability and access. No PBM has fully complied with the probe, FTC Chair Lina Khan said in a recent letter obtained by Axios

The Feb. 13 letter was sent to Republican Sen. Chuck Grassley, who had inquired about an update on the status of the probe. 

"Although our compulsory orders were issued in June 2022, and May and June 2023, to date no company has turned over sufficient documents and data to be in full compliance with those orders," Ms. Khan's letter said. "FTC staff continues to push the PBM/GPOs to finalize the production of documents and data required by the orders as quickly as possible." 

While the FTC expects to have materials related to the probe soon, Ms. Khan noted that the agency can take PBMs to court if they fail to fully comply with the orders, which were sent to the six largest PBMs: Caremark RX, Express Scripts, Optum Rx, Humana Pharmacy Solutions, Prime Therapeutics and MedImpact Healthcare Systems. 

On Feb. 27, the National Community Pharmacists Association released survey findings indicating nearly a third of independent pharmacies are considering shutting down this year, pointing to declining reimbursements and high back-end fees from PBMs. 

The group is urging Congress to support PBM reform. 

Efforts to advance federal legislation to reform PBM practices have stalled since May 2022, when bipartisan legislation that would allow the FTC to increase transparency around drug pricing and suppress certain PBM practices such as spread pricing, was introduced in the Senate.

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