FTC Undertakes Investigation Into PBMs

The Federal Trade Commission announced Tuesday that it had authorized an inquiry into the six largest pharmacy benefit managers: CVS Caremark, Express Scripts, OptumRx, Humana, Prime Therapeutics, and MedImpact Healthcare Systems. The agency is requiring each of the companies to provide information and records regarding their business practices.

Among the areas of inquiry are the prevalence of prior authorizations and other administrative restrictions; the use of specialty drug lists and surrounding specialty drug policies; and the impact of rebates and fees from drug manufacturers on formulary design and the costs of prescription drugs to payers and patients.

Administrative burden is consistently the top-ranked area of professional dissatisfaction among WAFP and AAFP members.