This overview is excerpted from Manatt on Health, Manatt’s subscription service that provides in-depth insights and analysis focused on the legal, policy and market developments.
On September 20, the Federal Trade Commission (FTC) filed its first administrative complaint against PBMs under Chair Lina Khan, alleging "anticompetitive and unfair rebating practices” by the three largest PBMs that have inflated insulin prices. While the complaint is focused specifically on insulin prices, complaint makes allegations similar to those leveled in the commission’s July interim report regarding PBM practices in general, alleging that PBMs control patients’ access to prescription drugs and benefit from higher list prices that allow larger rebates, excluding coverage of lower-cost options and harming patient access to prescription drugs.
Just days before the FTC’s insulin complaint was filed, Express Scripts, one of the three PBMs named in the complaint, filed suit in the U.S. District Court for the Eastern District of Missouri against the FTC over the interim PBM report, alleging that the interim report is defamatory and issued in violation of the Administrative Procedure Act, and the structure of the commission itself is unconstitutional.
