FTC halts case against PBMs, citing lack of commissioners

The Federal Trade Commission (FTC) has halted its lawsuit against the three largest pharmacy benefit managers (PBMs), citing a lack of commissioners willing to take up the case. 

The regulatory agency was suing CVS Caremark, Optum Rx and Express Scripts—along with their associated group purchasing organizations—over the price of insulin, alleging the companies were engaged in collusive practices to jack the  price for Americans. 

Despite winning a court battle that allowed the FTC’s case to move forward, the agency has now opted to press pause for 105 days, with an evidentiary hearing now scheduled for 225 days after the stay is lifted. 

The announcement comes after President Donald Trump fired high-level officials at the agency seen as Democrat opposition, namely Alvaro Bedoya and Rebecca Kelly Slaughter. They were fired in March and are currently suing to have their positions reinstated. The FTC has seen a major shakeup, with former head Lina Khan resigning when Trump took office on Jan. 20. She helped to craft the case against the drug distributors back in September. 

Republican commissioners have recused themselves, opting not to participate in the lawsuit. 

PBM reform has bipartisan support

Despite the seemingly partisan nature of the shifts, resistance of PBMs has garnered wide support, with Texas Attorney General Ken Paxton, a Republican, filing his own lawsuit that largely mirrored claims made by the FTC.

Paxton’s lawsuit also implicated drug manufacturers for their role in distributing “rebates” that allegedly artificially propped up the price of insulin. That case is still pending.

Chad Van Alstin Health Imaging Health Exec

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.

Around the web

Heartflow, known for its AI-based CCTA evaluations, appears to be going public. The news follows years of momentum for the California-based company, including improved Medicare reimbursements for cardiac CT and a new Category I CPT code for its Plaque Analysis software.

Suman Tandon, MD, an American Society of Nuclear Cardiology board member, explains the group's call on Congress to update a number of healthcare policies. 

The 2026 MPFS proposed rule includes higher conversion factors across the board. However, some cardiology groups remain concerned about a series of reimbursement reductions for high-value cardiology services.