Dive Brief:
- Cigna’s Express Scripts could be nearing a settlement with the Federal Trade Commission in the agency’s lawsuit accusing the largest pharmacy benefit managers in the U.S. of driving up insulin prices.
- The FTC has suspended proceedings against Cigna’s subsidiaries — including PBM Express Scripts, health services division Evernorth and group purchasing organization Ascent Health Services — so the agency can consider a proposed consent agreement that would “resolve the claims against the [Cigna] Respondents in their entirety,” the agency said in a Tuesday filing.
- The agency then paused the entire case on Wednesday for 14 days, arguing a stay would allow the suit to more easily move forward if a deal isn’t reached — and give the FTC time to “engage in parallel settlement discussions” with CVS and UnitedHealth, the other companies named in the suit.
Dive Insight:
The potential deal comes about a year and a half after the FTC first brought the case against Express Scripts, CVS’ Caremark and UnitedHealth’s Optum Rx. If approved, the agreement would mark the first settlement reached in the suit.
The FTC first sued the PBMs, influential middlemen in the drug supply chain, in September 2024. The agency alleged that the companies, known as the “Big Three” given they jointly control about 80% of U.S. prescriptions, steered patients toward higher priced insulin to bring in larger rebates from drug manufacturers.
The PBMs denied the allegations, arguing they pass most rebate savings on to their clients and save patients money by negotiating medication prices. In November 2024, the PBMs countersued the FTC over its complaint, arguing the suit was unconstitutional.
Still, PBMs have faced mounting scrutiny in recent years from lawmakers and regulators who argue their anticompetitive business practices are increasing drug costs.
Lawmakers have called PBM leaders to testify on Capitol Hill and proposed legislation to more strictly regulate them, including in a government funding deal currently under consideration in Congress.
The FTC and Cigna didn’t respond to requests for comment on the potential settlement by press time.
