The Federal Trade Commission (FTC) has reached a settlement with CVS Caremark, a leading U.S. pharmacy benefit manager, following allegations that the company artificially drove up insulin prices and restricted access to the essential diabetes medication.
Under the terms of the agreement, which the FTC anticipates will reduce out-of-pocket expenses for Americans by up to $8.5 billion over the next decade, CVS Caremark—a subsidiary of CVS Health—is required to implement several changes to its interactions with pharmacies, health plans, and employers. Additionally, the FTC projects that the settlement could generate up to $4.5 billion in additional savings for patients via pharmacy counter rebates.
The FTC’s initial complaint alleged that CVS Caremark, along with Express Scripts (owned by Cigna) and Optum Rx (owned by UnitedHealth), utilized a “perverse” rebate structure that prioritized insulin. The agency argued this system encouraged higher list prices to maximize profits, ultimately forcing patients to bear the brunt of increased medication costs.
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