The Federal Trade Commission is making “significant progress” in settlement talks with Optum Rx and Caremark, the agency disclosed in a court filing this week, increasing the likelihood that the two pharmacy benefit managers will follow in Express Scripts’ footsteps and agree to settle the high-profile case.
The FTC and Express Scripts reached a settlement in February allowing the company to bow out of the agency’s lawsuit against the influential drug middlemen for allegedly inflating the cost of U.S. insulin. The agreement, which included major reforms to Express Scripts’ business practices, likely increased pressure on Optum Rx and Caremark to also consider a settlement.
The case is now stayed until late March to allow the negotiations to continue, according to an order on Tuesday.
UnitedHealth, which owns Optum Rx, and CVS, which owns Caremark, declined to provide additional details on the negotiations.
But “we’re engaged in good-faith negotiations with the FTC, aimed at avoiding prolonged litigation and allowing CVS Caremark to keep doing what it does best: make prescription drugs more affordable in the US,” a Caremark spokesperson told Healthcare Dive.
The FTC sued Express Scripts, along with Optum Rx and Caremark, in September 2024, arguing the influential drug middlemen’s negotiating practices with drugmakers led them to prefer higher cost drugs, driving up the cost of lifesaving insulin.
However, the agency suspended action against Express Scripts in late January to consider the proposed settlement, and the two parties finalized the deal the following month.
The settlement is viewed as positive for the Cigna-owned PBM. It largely cemented reforms Express Scripts was already taking, so isn’t expected to affect its long-term profits, executives told investors after the deal was reached.
Meanwhile, federal regulators, which say the settlement will lower drug costs for consumers and increase transparency in the pharmaceutical supply chain, were also able to tout a win.
The lawsuit against Optum Rx and Caremark has continued. But “Complaint Counsel and Respondents are making significant progress in settlement discussions,” the parties wrote in their joint motion for a stay filed on Monday. “This extension of the stay will provide time for the parties to further advance these discussions and determine whether there is an opportunity to resolve this proceeding.”
