Welcome home, fellow Gator.

The Gator Nation's oldest and most active insider community
Join today!

FTC Charges Three Largest Middlemen made billions in drug profits

Discussion in 'Too Hot for Swamp Gas' started by G8trGr8t, Jan 15, 2025 at 4:36 PM.

  1. Jan 15, 2025 at 4:36 PM #1
    G8trGr8t

    G8trGr8t Premium Member

    32,969
    12,243
    3,693
    Aug 26, 2008
    Will we continue to see diligence like this under the new administration or will the fleecing of the working people of america continue? djt says he is going to knock out the middlemen, let musk focus on that

    FTC takes fresh swipe at drug middlemen, says some prices marked up over 1,000% | Morningstar

    The drug middlemen known as pharmacy-benefit managers took another body blow from regulators on Tuesday, as they were criticized for charging way more for some "critical" prescription drugs than it cost them.

    The Federal Trade Commission said in its second interim staff report on prescription-drug middlemen that the "significant markups" in prices above what the drugs cost generated an extra $7.3 billion in revenue for the three largest PBMs and their affiliated pharmacies from 2017 to 2022.

    The companies also generated about $1.4 billion in profit from "spread pricing," which entails billing their plan-sponsor clients for drugs more than what they reimburse pharmacies, according to the FTC. They also reimbursed their affiliated pharmacies more than they did unaffiliated pharmacies on almost every drug the FTC looked at.

    The so-called Big Three PBMs are CVS Health Corp.'s (CVS) CVS Caremark, Cigna Group's Express Scripts Inc. (CI) and UnitedHealth Group Inc.'s (UNH) Optum RX. The FTC report said the Big Three marked up prices for numerous specialty generic drugs, including those that treat cancer, heart disease and HIV, by "thousands of percent," and many others by "hundreds of percent."
     
  2. Jan 15, 2025 at 4:45 PM #2
    Gator515151

    Gator515151 GC Hall of Fame

    22,647
    1,041
    1,763
    Apr 4, 2007
    I realized how much these guys were screwing us last year when I reached the (doughnut hole) of my Medicare Advantage plan and the cost of my Farxiga went up to $150/month after Medicare and insurance covered their share. I told my Cardiologist I wasn't paying that much for a prescription that I'm not even sure if it is helping me. I told her it was not that I couldn't afford it just that I am a cheap bastard and was not going to overpay. She said "Let me see what I can do" The next day Orlando Health called me and said they would be delivering it to my door at no cost. That tells me somebody is making way too much money on that drug and many more.
     
    • Like Like x 1
    • Informative Informative x 1
  3. Jan 15, 2025 at 4:54 PM #3
    Gator515151

    Gator515151 GC Hall of Fame

    22,647
    1,041
    1,763
    Apr 4, 2007
    Just a tip to others out there who might have an expensive prescription that you are not happy paying for. I'm sure a lot of doctors out there can work with the providers to cut you a break. BTW the list price for Farxiga is $582 for 30 days for someone uninsured. I can't imagine no matter how much research and development went into it that not being a total rip off.
     
    Last edited: Jan 15, 2025 at 5:00 PM
  4. Jan 15, 2025 at 5:22 PM #4
    slocala

    slocala VIP Member

    3,364
    788
    2,028
    Jan 11, 2009
    This is a tough nut.

    Trigger warning…

    The pure capitalism of America should stir competition to drive efficiency and profits to the best service and value. When we have a market with limited players and patents that control profits, someone has to pay for the value created by the inventor. Unfortunately, that means that the poor may not get the Ferrari of drugs. There is a misnomer that drugs should be democratically allocated. That just isn’t true. When it goes generic, it is open competition. I think Mark Cuban has it right that the PBM’s need to be taken out.
     
    • Agree Agree x 1
  5. Jan 15, 2025 at 8:30 PM #5
    slayerxing

    slayerxing GC Hall of Fame

    5,068
    866
    2,078
    Aug 14, 2007
    What's sad is that there is some really interesting research going on, especially on one pill "wonder drugs" that can literally treat rare genetic conditions.
    10 Most Expensive Drugs in the US, Period - GoodRx
    #6 on this list I actually know people that worked on it- literally cures a form of genetic blindness with one treatment. These drugs are AMAZING. But the cost to research and develop them is extensive. I'm not sure what the answer is - but these middle men... NOT the answer.
     
    • Informative Informative x 1
  6. Jan 15, 2025 at 8:34 PM #6
    sierragator

    sierragator GC Hall of Fame

    15,772
    13,335
    1,853
    Apr 8, 2007
    Not holding my breath on big pharma being stopped from screwing us all without lubrication and twice on Sunday.
     
    • Agree Agree x 1
  7. Jan 15, 2025 at 10:21 PM #7
    OklahomaGator

    OklahomaGator Jedi Administrator Moderator VIP Member

    124,356
    164,288
    116,973
    Apr 3, 2007
    My best friend in OK is a pharmacist and he has nothing good to say about PBMs. They cost the consumer money.
     
    • Agree Agree x 1
    • Informative Informative x 1