- The Federal Trade Commission told two group purchasing organizations to supply information and records on their business practices as part of a larger probe of pharmacy benefit managers.
- Zinc Health Services, founded in 2020, and Ascent Health Services, founded in 2019, will have 90 days to respond after receiving the orders, the FTC said Wednesday. Zinc negotiates rebates with drugmakers on behalf of CVS Caremark, while Ascent works with Express Scripts, Prime Therapeutics, Envolve Pharmacy Solutions and Humana Pharmacy Solutions, the FTC said.
- The FTC took the latest step almost a year after issuing similar orders to the six largest PBMS: CVS Caremark, Express Scripts, OptumRx, Humana Pharmacy Solutions, Prime Therapeutics and MedImpact Healthcare Systems. The agency issued the orders under its authority “to conduct studies without a specific law enforcement purpose.”
The new orders reflect an agency increasingly focused on potential antitrust practices throughout the prescription drug industry. A day earlier, the FTC sued to block Amgen’s $27.8 billion takeover of Horizon Therapeutics, alleging Amgen would be able to use its position in the pharmaceutical market to guard monopolies for two Horizon medicines.
The move was a departure for an agency that in the past typically focused on overlaps in a particular therapeutic area when evaluating potential mergers. One major example in recent years was the FTC requirement that Celgene sell its psoriasis drug Otezla before the company’s purchase by Bristol Myers Squibb.
In the Amgen case, the FTC zeroed in on a practice called cross-market bundling, where drugmakers offer rebates on “must-have” products in exchange for getting other drugs premier placements on insurer and PBM lists of covered medications. The practice is at the heart of a lawsuit filed against Amgen by Regeneron, and Regeneron CEO Leonard Schleifer applauded the FTC’s move.
Similar concerns are propelling the inquiry into PBMs, the middlemen that play a key role in the process of getting medicines from a manufacturer to a patient. The largest ones are integrated with top insurance companies and have tremendous influence over prescriptions and patient costs, the FTC said. Their practices have drawn complaints, especially from independent pharmacies.
In its review, the FTC is focused on PBM practices including their negotiations of fees and rebates with drugmakers that may skew formularies and result in higher costs to consumers. It’s also looking at “complicated and opaque” pharmacy reimbursement methods, fees charged to unaffiliated pharmacies and the practice of steering patients toward PBM-owned pharmacies.