Express Scripts considering settlement with FTC to resolve insulin pricing dispute, filing reveals
Despite the Federal Trade Commission pausing its lawsuit against the nation’s three largest pharmacy benefit managers (PBMs) last year, the agency has updated its court filing to specifically halt litigation altogether against Cigna, the owner of Express Scripts, citing a potential resolution between the parties. The group purchasing organization (GPO) part of the vertical, Ascent Health Services, was also a defendant—litigation against that entity may also be dropped.
The FTC said it’s considering a settlement with Cigna and its two subsidiaries to resolve the case against it before litigation unfolds. The regulatory agency is suing the PBM and GPO, along with its parent company, over accusations they artificially inflated the price of insulin, in violation of federal antitrust laws.
Cigna has not confirmed in any statement or filing with the Securities and Exchange Commission that settlement negotiations are ongoing. However, the FTC only submitted documents alluding to a potential settlement on Jan. 20.
The agency said the suspension of its claim was pursuant to an agreement—but there were no details revealed.
On Feb. 3, that stay will be lifted, but an extension could also be put in place.
The FTC has had trouble pursuing the case, citing a lack of commissioners willing to advance the formal complaint. It’s been effectively on hold since April 2024.
Named in the lawsuit as primary defendants were the “Big Three” PBMs—Optum Rx, Express Scripts and CVS Caremark. All have denied wrongdoing, arguing that they do not set the price of insulin as the FTC alleges.
Multiple lawsuits focused on insulin
The FTC case is focused on the use of rebates, handed out by drug manufacturers that are then passed onto GPOs, who distribute them down the chain to their associated PBMs and partner pharmacies. The agency argues that this is a de facto price control, as it allows discounts to only reach entities within a single company’s larger vertical, to the detriment of independent pharmacies.
In a similar lawsuit, Texas Attorney General Ken Paxton claimed the PBMs and drug companies are “artificially and willingly” raising the price of insulin by controlling the supply chain. Texas, too, is using insulin as its primary focus for its complaint, given its rise from $20 to $300 a vial since 1990.
Both lawsuits were filed in 2024.
Missouri was the most recent state to sue the same defendants, announcing its federal court filing earlier this month. Much like the FTC and Texas, the complaint is focused on drug rebates and how those impact the price of insulin.
All of the above litigation is pending.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.