Boom! FTC Squeezes Concessions from Cigna's Express Scripts

Core Insights - The Federal Trade Commission (FTC) announced that Cigna has agreed to significant concessions to address unfair business practices that have led to higher drug prices and harmed independent pharmacies [1][2] Group 1: Settlement Details - The settlement aims to lower consumer copays linked to inflated drug prices driven by Cigna's rebate and fee practices [2] - Cigna's Express Scripts is required to eliminate spread pricing and decouple rebates and fees from drug list prices [3] - Cigna's Group Purchasing Organization (GPO), Ascent, must relocate from Switzerland to the U.S. and will be monitored by the FTC for 10 years [3] Group 2: Impact on Pharmacies - The settlement mandates the adoption of a cost-plus reimbursement model for independent pharmacies in commercial plans starting in 2027 or sooner [3] - This cost-plus model is crucial for ensuring pharmacies are reimbursed adequately to cover their operational costs and maintain profitability [4] - Below-cost reimbursements have contributed to the emergence of pharmacy deserts, where patients lack access to local healthcare providers [4] Group 3: Industry Implications - The settlement is seen as a significant step towards addressing anticompetitive practices in the pharmacy benefit manager (PBM) industry [2][3] - Employers are encouraged to reconsider their drug benefit plans to ensure better access to pharmacies and lower drug costs for employees [4]