High insulin prices spur a federal lawsuit against three pharmacy benefit managers

abcnews.go.com:

The federal government is suing some pharmacy benefit managers over a system of drug rebates that regulators say has made the price of insulin soar for patients

The federal government is suing some big pharmacy benefit managers over a system of drug rebates that regulators say has made the price of insulin soar for diabetic patients.

Three companies that process about 80% of prescriptions in the United States — Caremark, Express Scripts and OptumRx — have engaged in anticompetitive practices that spur price increases, the Federal Trade Commission alleged in a lawsuit filed Friday.

Pharmacy benefit managers, or PBMs, run prescription drug coverage for insurers, large employers and other clients. They set up formularies, or lists of covered drugs, and negotiate rebates off the drug prices.

The FTC said the rebating practices of the three companies have led to artificially inflated list prices for people. List prices are what a drugmaker initially sets for a product and what people who have no insurance or plans with high deductibles are sometimes stuck paying for prescriptions.

The price of insulin has emerged as a big campaign topic during this year’s presidential election.

For years, pharmacy benefit managers have been the target of ire for politicians, patients and others. But PBMs have said they play an important role in controlling drug costs and pass along most of the discounts they negotiate to their clients.

Some of the PBMs named by the FTC said in statements that the government's action showed that it does not understand how drug pricing works.

But the FTC said the current system prioritizes insulins that come with high list prices and excludes lower-priced products. That, the FTC said, helped PBMs and their