UnitedHealth, CVS Caremark, Express Scripts sued by FTC over skyrocketing insulin prices

Core Allegations - The Federal Trade Commission (FTC) sued the three largest pharmacy benefit managers (PBMs) in the US, accusing them of steering diabetes patients towards higher-priced insulin to earn millions in rebates from pharmaceutical companies [1] - The PBMs allegedly excluded lower-cost insulin products from insurers' drug coverage lists, harming patients with coinsurance and deductibles who did not qualify for rebated prices [1] Market Dominance - The three PBMs—UnitedHealth Group's Optum, CVS Health's CVS Caremark, and Cigna's Express Scripts—administer 80% of all prescriptions in the US [2] Company Responses - CVS defended its efforts to make insulin more affordable, calling the FTC's allegations "simply wrong" and emphasizing its record of protecting patients from rising drug prices [2] - Cigna criticized the FTC for pursuing political points, arguing that forcing PBMs to include higher-cost drugs would increase overall drug prices [2] - Optum Rx dismissed the lawsuit as baseless, claiming it has reduced insulin costs for customers to an average of less than $18 per month [2] Stock Market Impact - CVS shares fell 1.6% in midday trading, while UnitedHealth and Cigna shares saw marginal declines [3] FTC's Perspective - The FTC described the PBMs as "medication gatekeepers" that have extracted millions from patients needing life-saving medications [4] - The agency criticized the role of major insulin manufacturers—Eli Lilly, Sanofi, and Novo Nordisk—in a "broken system" but did not sue them, reserving the right to do so later [4] Industry Dynamics - CVS Caremark argued that limiting PBMs' ability to negotiate drug prices would primarily benefit pharmaceutical companies [5] - The PBMs accused the FTC of bias, with Express Scripts suing the agency earlier in the week to withdraw a report claiming PBMs profit at the expense of smaller pharmacies [5] - The case will be heard by an FTC administrative law judge, with the process expected to move quickly and involve extensive evidence exchange [5]