Ted Okon: FTC Should Set Up Guardrails to Protect Americans From PBM Practices

As part of the investigation into pharmacy benefit managers (PBMs), the Federal Trade Commission (FTC) should delve into how PBMs are impacting and fueling drug prices and set up guardrails to protect Americans, said Ted Okon, MBA, executive director, Community Oncology Alliance.

Transcript

What are your hopes for the FTC investigation into PBM practices?

I think it's really [ground]breaking to have the FTC look at PBMs and the abuses that PBMs basically foist on society. What I hope is that the [FTC] really delves into what's happening with PBMs, how they are impacting and fueling drug prices, how they are adversely impacting care, especially for cancer patients, and ideally, I'd like to see the FTC break up the PBMs and the insurers.

It's a real problem when you have the top 3 PBMs literally control 80% of the prescription drug market. Add 3 more on to that, and they control 96%. And it gets even worse when you realize that those top 3 PBMs basically are owned by or own the number 1, 3, and 4 insurers.

So, I think that at the very least, the FTC has to put in place guardrails that protect Americans from PBM abuses. But ideally, I'd like to see them break up the PBMs and the insurers. It never should have been the case that we see the consolidation in the PBM market and the consolidation between PBMs and insurers.