Comer Applauds FTC Action on PBMs’ Anticompetitive Tactics Driving Up the Cost of Insulin

WASHINGTON—House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) today applauded the Federal Trade Commission (FTC) for taking action against the three largest pharmacy benefit managers (PBMs) and their group purchasing organizations for engaging in anticompetitive tactics and rebate practices that are artificially inflating the price of insulin drugs:

“Today’s action by the FTC is a direct result of the House Oversight Committee’s investigation that has exposed PBMs’ anticompetitive tactics driving up the cost of prescription drug prices for Americans and jeopardizing patient care. Our investigation, which culminated in a report with our findings and recommendations, found PBMs have largely operated in the dark and abused their position as middlemen to line their own pockets by passing on costs to patients. These self-benefitting tactics raise prescription drug prices, like insulin, undermine community pharmacies, and harm Americans who need access to life-saving medication. Congress and states must implement legislative reforms to increase the transparency of the PBM market and the House Oversight Committee will continue to do its part to ensure Americans have access to affordable medication.”

The House Oversight Committee has exposed PBMs anticompetitive tactics and has provided solutions to make prescription drugs more affordable for all Americans.

Investigation: At the start of the 118th Congress, Chairman Comer initiated an investigation of PBMs’ self-benefitting pricing tactics that jeopardize patient care, undermine local pharmacies, and raise prescription drug prices.

Hearings: The Oversight Committee has held three hearings to expose harmful PBM practices and identify solutions.

• At the first hearing, members heard from community pharmacists, a medical oncologist, and a transparent PBM, as they examined PBMs’ tactics at multiple levels of the payment and supply chains that are increasing costs for consumers and harming patient care.
• At the second hearing, members and witnesses highlighted how PBMs have monopolized the pharmaceutical marketplace and pushed anticompetitive practices that undermine patient health and deliberately drive up the cost of prescription drugs.
• At the third hearing, members pressed PBM chief executives on their role in rising prescription drug costs.

Getting Lifesaving Medicine to Americans: At the hearing with PBM chief executives, Rep. Buddy Carter exposed how CVS Caremark denied Mattie, one of his constituents, access to a lifesaving drug he had been on for two years and almost died as a result. After the hearing, CVS Caremark approved Mattie’s medicine.

Exposed PBMs’ Anticompetitive Tactics: The House Oversight Committee issued a report showing how PBMs inflate prescription drug costs and interfere with patient care for their own financial benefit. The report concludes that the present role of PBMs in prescription drug markets is failing and requires Congress and states to implement legislative reforms to increase the transparency of the PBM market.

Called on PBM Executives to Correct Hearing Testimony: Chairman James Comer called on the CEOs of three major PBMs—CVS Caremark, Express Scripts, and Optum Rx—to correct the record for statements made during their appearance before the House Oversight Committee at a hearing.

Passed the DRUG Act: The Oversight Committee passed the DRUG Act, which creates certain requirements for PBMs that contract with a carrier offering health benefits plans offered under the Federal Employees Health Benefits program, including de-linking PBM profits from rebates and fees in order to bring down the cost of prescriptions.