A pair of U.S. lawmakers is urging the Federal Trade Commission to investigate the parent companies of two large pharmacy benefit managers over concerns that new business units might unfairly steer patients toward higher-cost medicines.
The effort comes after CVS Health and Cigna — which own CVS Caremark and Express Scripts, respectively — launched subsidiaries that are striking “co-manufacturing” deals with companies that make biologic medicines and lower-cost versions known as biosimilars. These new business units have since used these deals as springboards to market the medications to health plans.
In reality, the arrangements actually resemble private-label distribution, but the lawmakers worry these agreements could cause consumers to pay higher prices. How so? The business units are now competing with pharmaceutical companies for placement on formularies — the list of medicines covered by health insurance — and the lawmakers argue there are incentives to favor the drugs they are supplying.
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