The Pharmacy Benefit Managers (PBMs) marked up the cost of some prescription drugs by 1,000%, according to a report from the Federal Trade Commission (FTC). Some of the drugs with significant price jumps included those for HIV and cancer.
The PBMs, which the FTC calls the “prescription drug middleman,” include Caremark Rx, LLC (CVS), Express Scripts, Inc. (ESI), and OptumRx, Inc. (OptumRx).
According to the FTC’s report, the markups resulted in the PMS generating more than $7.3 billion in revenue. The revenues were made while “patient, employer, and other health care plan sponsor payments for drugs steadily increased annually,” the agency said.
“Among the specialty generic drugs dispensed by PBM-affiliated pharmacies for commercial health plan members, 22 percent (10 out of the 46 drugs in our sample during this period) were marked up more than 1,000 percent, with 50 percent of these marked up more than 2,000 percent, while 41 percent (19 drugs) were marked up between 100 and 1,000 percent (median = 223 percent),” the report explains. “Another 20 percent (nine drugs) were marked up between 10 and 100 percent, while only 17 percent (eight drugs) were marked up by less than 10 percent.”
The report noted that the majority of the “most highly marked up specialty generic drugs were dispensed by PBM-affiliated pharmacies.”
FTC Chair Lina M. Khan said in a statement, “The FTC staff’s second interim report finds that the three major pharmacy benefit managers hiked costs for a wide range of lifesaving drugs, including medications to treat heart disease and cancer. The FTC should keep using its tools to investigate practices that may inflate drug costs, squeeze independent pharmacies, and deprive Americans of affordable, accessible healthcare—and should act swiftly to stop any illegal conduct.”
