The Federal Trade Commission (FTC) has reached a proposed consent agreement with Express Scripts following allegations of insulin price inflation. The agreement comes after the FTC filed an administrative complaint in 2024 against CVS Caremark, Express Scripts—owned by Cigna—and Optum Rx, which is owned by UnitedHealth Group, as well as related rebate and group purchasing organization entities.
According to Michael Baker, Director of Health Care Policy at American Action Forum, the settlement requires Express Scripts and its affiliates to make several changes. These include restructuring their proprietary formulary, passing net pricing through to employer plans, enhancing business transparency, and incorporating a new measure: counting member payments made via TrumpRx toward plan deductibles.
Baker noted that while these remedies are legally permissible, they may have broader effects on an already highly regulated market. He stated that “the overarching construct of this settlement creates several concerning ripple effects in what is a highly regulated market and does nothing to alleviate underlying cost and price issues in health care.”
