Dive Brief:
- The Federal Trade Commission is calling on the public to submit feedback on how pharmacy benefit managers' business practices are affecting patients, pharmacies and employers.
- The agency is seeking to gather a wide range of information and comments on pharmacy benefit managers, including how they affect drug prices, access, contract terms, rebates, fees, steering methods, conflicts of interest and consolidation, according to the request for information released Thursday.
- Members of the public can comment through April 25. The information the FTC collects will enable the agency to "study a wide array of PBM business practices and issues and will help inform the agency's policy and enforcement work," the regulator said in a statement.
Dive Insight:
The request for information comes on the heels of the FTC's failed bid to launch a formal inquiry into PBM practices that would have required some of the nation's largest PBMs to turnover information and documents to the agency.
Last week, FTC commissioners were at an impasse on launching an investigation into PBMs' drug-pricing practices and how those practices ultimately "may disadvantage independent or specialty pharmacies," according to last week's agenda.
The commissioners needed a simple majority to launch the inquiry. It failed as commissioners were deadlocked, 2-2, even after hearing impassioned comments from pharmacists around the country that detailed how they're being harmed by PBMs opaque and complex ways of doing business.
Last week, FTC Chair Lina Khan said she was disappointed by the outcome, especially after months of gathering information on PBMs, including from patients, "underscoring the real urgency and life and death stakes in some instances."
PBMs serve as the middlemen between drug manufacturers, health plans and pharmacies. They manage prescription drugs for millions of Americans, essentially serving as a gatekeeper with the power to decide which drugs are covered and which are not. They negotiate discounts and rebates with drug manufacturers. The nation's largest PBMs are owned by the nation's largest insurance companies.
In its RFI, the FTC posted some areas it's interested in pursuing, a few of which are posted below:
- The impact of PBM rebates and fees on net drug prices to patients, employers and other payers.
- The impact of PBM rebates and fees on formulary design and patients' ability to access prescribed medications without endangering their health, creating unnecessary delay or imposing administrative burdens for patients or prescribers.
- Whether patients are being forced to substitute different prescription drugs to maximize PBM rebates and fees.