FTC widens probe into pharmacy benefit managers

2023-05-18

The US Federal Trade Commission is seeking information from two privately held companies that negotiate drug rebates on behalf of pharmacy benefit managers (PBMs). The request to Zinc Health Services and Ascent Health Services was made as part of the regulator's ongoing probe into how PBMs affect prescription drug pricing in the country.

Last year, the FTC opened an investigation into PBMs by issuing compulsory orders to six of the largest prescription drug middlemen in the US – CVS Caremark, Express Scripts, OptumRx, Humana, Prime Therapeutics and MedImpact Healthcare Systems – to provide information and records regarding their business practices.

The agency said its inquiry aims to shed light on several PBM practices, including charging fees and clawbacks to unaffiliated pharmacies, steering patients towards PBM-owned pharmacies, and using "complicated and opaque" pharmacy reimbursement methods, as well as negotiating rebates and fees with drugmakers that may impact the costs of prescription drugs to payers and patients.

Zinc and Ascent are group purchasing organisations (GPOs) that negotiate after-market discounts or rebates with drug manufacturers on behalf of PBMs and hold the contracts that govern those rebates, the FTC said. As with the previous compulsory orders, the two new ones will require both Zinc and Ascent to provide information and records on their business practices.

Zinc was founded in 2020 and operates as the GPO for CVS Caremark, while Ascent was founded in 2019 and operates as a GPO for Express Scripts, Prime Therapeutics, Envolve Pharmacy Solutions and Humana Pharmacy Solutions.

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