FTC Report Reveals $7.3 Billion in Drug Markups by Leading PBMs

The Big Three pharmacy benefit managers inflated prices of specialty generics by up to 8,000%, raising concerns over healthcare costs and market dominance.

The Federal Trade Commission found that CVS Caremark, Cigna’s Express Scripts, and UnitedHealth’s OptumRx marked up specialty generic drugs by hundreds to thousands of percent between 2017 and 2022.
The report highlighted $7.3 billion in revenue generated by these markups, primarily affecting treatments for cancer, HIV, and heart disease.
Nearly 22% of analyzed specialty drugs were marked up by over 1,000%, with some exceeding 7,000%, significantly increasing costs for patients and health plan sponsors.
The FTC's findings have renewed bipartisan calls for legislation to increase transparency and accountability in the PBM industry.
PBM-affiliated pharmacies were found to benefit disproportionately, while independent pharmacies and patients faced higher costs and reduced access.