The pharmacy benefits landscape may be shifting with the new Federal Trade Commission appointee Alvaro Bedoya. He should be the tie-breaker in the 2-2 gridlock that has plagued the commission. One of the stymied issues has been whether the FTC should move forward in its investigation into the cost of insulin.
Three US Senators, Sen. Chuck Grassley (IA), Sen. Mike Braun (IN), and Sen. Ron Wyden (OR) submitted a formal letter to FTC chair Lina Khan this week requesting the watchdog government organization investigate potential manufacturer and PBM anti-competitive practices in the insulin market.
This recent move is not Sen. Grassley’s first rodeo regarding insulin costs. In April, Sen. Grassley and Sen. Wyden released an 88-page report, the culmination of a two-year investigation from the Senate Finance Committee into the three largest insulin manufacturers (Sanofi, Novo Nordisk, and Eli Lilly) and the largest PBMs.
It’s not clear what the FTC will do even if they do find anti-competitive practices at play. One thing is clear, this tactic by the Senators is an act of desperation. Congress has been incapable of making a policy change that would help Americans with their drug costs and unfair pricing practices that we all have seen on display over the past ten years. Maybe the FTC will fine the companies if they find evidence of price-fixing but the fines will have to be substantial to make a dent in the profits for insulin.
Congress could be doing more to address high drug costs by considering the total landscape of consumer drug prices. RazorMetrics is working to help self-funded employers and health plans control their drug costs by matching up their formulary with the prescriptions of their members to take advantage of the hard work that is done designing formularies, rebates, and discounts. There are mechanisms in place, but this money is largely left on the table. Congress should start thinking outside the pill bottle to help Americans with their prescriptions. Read more:
