FTC seeks more time to settle insulin pricing lawsuit with remaining PBM defendants
Roughly a month after the Federal Trade Commission (FTC) settled its lawsuit with pharmacy benefit manager (PBM) Express Scripts, it appears the other defendants in the pending case over the high price of insulin may be ready to make deals of their own.
In a March filing, the FTC updated the court, telling a judge that it has made “significant progress in settlement discussions” with the remaining two PBMs it targeted in its insulin price control lawsuit, Optum Rx and CVS Caremark—owned by UnitedHealth Group and CVS Health, respectively.
It’s unclear what the agreements with the PBMs—referred to, along with Express Scripts, as “the Big Three” by the FTC when it announced its lawsuit in September 2024—will look like. However, the deal with Express Scripts did stipulate that it would begin selling drugs through the TrumpRx.gov marketplace.
TrumpRx is a direct-to-consumer program President Donald Trump established initially as a pathway for pharmaceutical companies to avoid tariffs. Companies who participate agree to sell their medications at a cash rate, lower than what they typically charge insurance companies.
It’s not clear if Optum Rx and Caremark will also agree to that condition. For now, the FTC is simply requesting more time to continue negotiations.
The agency asked a judge to provide an additional 21 days to “provide time for the parties to further advance these discussions and determine whether there is an opportunity to resolve this proceeding.”
That means, the lawsuit against two of the Big Three is on pause until late March at the earliest.
Rebates under scrutiny
Shortly after filing its lawsuit in September 2024, Texas filed a similar lawsuit against Express Scripts, Optum Rx and Caremark, naming drug manufacturers as co-defendants. Both complaints centered around the use of confusing rebates, where insulin discounts are passed on to pharmacies and organizations friendly with each company’s vertical, leaving others stuck paying an inflated price that offsets those same discounts.
As part of its truce with the FTC, Express Scripts agreed to charge patients and health plans a price for insulin that reflects all rebates and discounts—meaning rebates are still a legitimate practice, but only if they’re passed on down the supply chain.
It remains to be seen if the price of insulin will actually go down under these conditions. A vial of insulin currently costs over $300, Texas and the FTC noted in their lawsuits.
In the 1990s, the same vial was priced at only $20.
This is a developing story.
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.