Dive Brief:
- UnitedHealth has reached a tentative settlement with the Federal Trade Commission in the agency’s lawsuit against the nation’s three largest pharmacy benefit managers for allegedly inflating the cost of insulin.
- The FTC is pausing the case against UnitedHealth’s PBM Optum Rx and its group purchasing organization Emisar. The agency will consider a proposed consent agreement that would “resolve the claims against the Optum Respondents in their entirety” if approved by FTC leadership, according to an order released Friday.
- The potential deal comes nearly three months after CVS Health reached a proposed settlement with the agency. Cigna’s Express Scripts settled its case with the FTC early this year.
Dive Insight:
The FTC sued the “Big Three” PBMs — which jointly control about 80% of U.S. prescriptions — in 2024 for allegedly driving up the price of insulin through uncompetitive business practices, like steering patients toward higher cost medications to scoop up higher rebates from drug manufacturers.
CVS’ Caremark, Express Scripts and Optum Rx have denied the agency’s allegations. But the drug middlemen have each moved towards settlements with the FTC this year.
Express Scripts reached a deal with the FTC in early February. The settlement required the PBM to delink its compensation from savings it negotiates with pharmaceutical companies and stop preferring medications with high list prices, among other requirements.
CVS reached a proposed settlement with the agency in late March, though the deal hasn’t been finalized. Now, Optum Rx appears close to an agreement.
The proposed consent agreement has been approved by directors of the FTC’s bureaus of competition and consumer protection, according to the order released Friday. Details of the deal weren’t disclosed.
Optum Rx didn’t immediately respond to a request for comment. An FTC spokesperson said the agency had no comment.
