FTC Expands Study of PBM Drug Pricing

AMI has included a number of PBM-lead GPOs and Medication Contracting Organizations in the GPO 2023-2024 Annual Review. These organizations are not actual group purchasing organizations according to industry definitions, but they are making inroads into the market by aggregating purchasing volume to negotiate discounts. AMI plans to publish an in-depth report in the fall of 2023 on these companies.

The Federal Trade Commission has issued a compulsory order to a third group purchasing organization (GPO) that negotiates drug rebates on behalf of PBMs. The compulsory order will require the GPO entity to provide information and records on its business practices.

Having previously issued compulsory orders to the six largest PBMs and recently to two PBM-affiliated GPO’s, Zinc Health Services, LLC (Zinc) and Ascent Health Services, LLC (Ascent), today the FTC issued an order to Emisar Pharma Services LLC (Emisar).

OptumRx formed Emisar in 2021, an Ireland-based company to handle rebate negotiations for UnitedHealthcare members. Emisar™ trademark registration is intended to cover the categories of business consulting and management services in the fields of prescription drugs and cost management of health care

Emisar, like Zinc and Ascent, negotiates rebates with drug manufacturers. Emisar negotiates these rebates on behalf of OptumRx and, like OptumRx, is a subsidiary of UnitedHealth Group. The Order to Emisar is substantially similar to the orders recently issued to Zinc and Ascent.

The FTC is issuing the order under Section 6(b) of the FTC Act, which authorizes the Commission to conduct studies without a specific law enforcement purpose. The company will have 90 days from the date it receives the order to respond.

The Commission voted 3-0 to issue the Section 6(b) order to Emisar as part of the FTC’s study of PBMs’ business practices.

 

Takeaway: The FTC is expanding its ongoing study on pharmacy benefit managers (PBMs) and their impact on the accessibility and affordability of prescription drugs