FTC says ‘Big 3 PBMs’ marked up generic drugs by thousands of percent

The Federal Trade Commission published a second interim staff report on the prescription drug middleman industry, which it says focuses on pharmacy benefit managers’ influence over specialty generic drugs, “including significant price markups by PBMs for cancer, HIV, and a variety of other critical drugs.” The agency’s report found that the “Big 3 PBMs” – CVS Health’s (CVS) Caremark Rx, UnitedHealth’s (UNH) OptumRx, and Cigna’s (CI) Express Scripts – marked up “numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent.” Such significant markups allowed the companies and their affiliated specialty pharmacies to generate more than $7.3B in revenue from dispensing drugs in excess of the drugs’ estimated acquisition costs from 2017-2022, according to the FTC.