The Federal Trade Commission is preparing lawsuits against UnitedHealth Group, Cigna and CVS Health over their PBM business practices, according to reporting from The Wall Street Journal. The three companies operate the largest PBMs in the U.S., OptumRx, Express Scripts and CVS Caremark, respectively.
In calls with investors, the CEOs of CVS Health and Cigna said their PBMs save customers money, and promised to defend their businesses in Washington.
Karen Lynch, CEO of CVS, told investors on an Aug. 7 call the company has “taken a very aggressive approach to educating Congress on the role of the PBM.”
While lawmakers on both sides of the aisle have accused PBMs of driving up drug prices for consumers for years, the issue reentered the spotlight when the FTC published a report in July. The commission’s report alleged PBMs show favoritism toward their own pharmacies and hold vast market control, affecting both medication access and affordability.
Ms. Lynch told investors the report was “very targeted.”
“[The FTC] took certain data, and not the holistic data, to amplify their story versus the real story,” she said.
David Joyner, CEO of CVS Caremark, said messaging that PBMs reduce costs are not resonating because lawmakers are focused on the high brand costs of drugs.
“The PBM industry and specifically CVS Caremark create significant value. Once the empirical evidence is there and begins to get to those at the legislative branch, and those writing about this industry, the numbers will speak for themselves,” he said.
Cigna, which operates Express Scripts, also told investors it is planning aggressive campaigns to convince lawmakers and the public on the value of its PBM.
“We challenge ourselves to be much more aggressive and complete relative to communication and engagement in support of our clients, be they employers or health plan customers, collaborating even more deeply and intensely with independent pharmacies … and working on the Hill, of course,” CEO David Cordani said Aug. 1.
Executives for UnitedHealth, which operates OptumRx, did not address the scrutiny around PBMs on its most recent earnings call, but said the company is focused on meeting the needs of its clients.
“We serve at the privilege of our clients,” Heather Cianfrocco, CEO of Optum, said July 16. “What they need, we serve. We administer their benefits ,and we offer the programs, services to drive affordability of medications for them, in the best interest of their members.”
