News & Analysis as of

Pharmacy Benefit Manager (PBM) Competition

Goodwin

DOJ and FTC Host ‘Listening Sessions’ on Competition Issues in the Pharmaceutical Industry

Goodwin on

In two recent public panels, the Department of Justice (DOJ) and the Federal Trade Commission (FTC) hosted the first of three joint listening sessions mandated by Executive Order No. 14273, Lowering Drug Prices by Once Again...more

Haug Partners LLP

Regeneron Pharmaceuticals, Inc. v. Amgen Inc.: Jury Finds Rebate Offers on Bundled Drugs in Exchange for Exclusive Formulary...

Haug Partners LLP on

On May 15, 2025, a federal jury in Delaware district court determined that Defendant Amgen Inc. (“Amgen”) violated antitrust and tort laws, and awarded $406.8 million in damages to Plaintiff Regeneron Pharmaceuticals, Inc....more

Mintz - Health Care Viewpoints

Arkansas Law Takes Unprecedented Step to Prohibit PBM Ownership of Pharmacies

On April 16, 2025, Arkansas Governor Sarah Huckabee Sanders signed into law House Bill 1150, now Act 624 (the Act), making Arkansas the first state in the nation to prohibit pharmacy benefit managers (PBMs) from acquiring or...more

Kerr Russell

Michigan AG Alleges Anticompetitive Agreement Between Pharmacy Benefit Managers

Kerr Russell on

Michigan Attorney General Dana Nessel sued Express Scripts Inc. and Prime Therapeutics LLC, two pharmacy benefit managers (PBMs), in the U.S. District Court for the Eastern District of Michigan on Monday, April 28, 2025....more

King & Spalding

Antitrust Concerns with Network Rental Agreements

King & Spalding on

How a common practice for healthcare payers can turn from negotiation tactic to anticompetitive collusion - What is a network rental agreement? Network rental agreements, also known as “network leasing” or “network...more

Maynard Nexsen

Prescription Revolution: Trump’s Bold Move to Slash Drug Prices

Maynard Nexsen on

An Overview of the Executive Order on Lowering Drug Prices - On April 15, 2025, President Donald J. Trump signed an Executive Order aimed at reducing prescription drug prices in the United States. This order builds upon...more

Maynard Nexsen

Key Health Care Issues to Track in 2025 in Alabama

Maynard Nexsen on

This update examines the shifting landscape of healthcare regulation and industry developments in Alabama. It addresses key areas affecting healthcare, such as the ongoing expansion efforts by Alabama providers, significant...more

Goodwin

Antitrust and Competition Life Sciences Year in Review 2024

Goodwin on

The last year (and particularly the last few months) of the Biden Administration brought a flurry of activity from the Federal Trade Commission (FTC) in the life sciences space, continuing a yearslong pattern of close...more

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

Quarles & Brady LLP on

On December 11, 2024, a bill was introduced in the U.S. House of Representatives that, if enacted, would have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country. Titled the...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Axinn, Veltrop & Harkrider LLP

The Fate of the “Last Gasp” of the Biden FTC: Will Its Legacy Survive the Trump Administration?

In the days leading up to President Trump’s inauguration, the Biden FTC rushed to initiate major lawsuits and to tie a bow on various antitrust policy efforts. In a series of dissenting statements, the minority Republican...more

Mintz - Antitrust Viewpoints

PBM Update: Special Edition - FTC Releases Second Interim Staff Report in PBM Inquiry

On January 14, 2025, the Federal Trade Commission (FTC) Office of Policy Planning released a second Interim Staff Report titled Specialty Generic Drugs: A Growing Profit Center for Vertically Integrated Pharmacy Benefit...more

McCarter & English, LLP

FTC Issues PBM Report Signaling Consolidation Is Impacting Pharmaceutical Prices

At a public meeting held on January 15, 2025, the Federal Trade Commission (FTC) summarized the Second Interim Staff Report (Second Report) stemming from its investigation into pharmacy benefit managers (PBMs) and their...more

BakerHostetler

Jan. 14 - Likely the FTC’s Final Open Commission Meeting

BakerHostetler on

On Jan. 14, Lina Khan chaired what was likely the final open commission meeting of her time as chair of the Federal Trade Commission (FTC) and perhaps the final open commission meeting for the foreseeable future....more

Wiley Rein LLP

PBM Contracting and Administration: What Are the Rules of the Road for Self-Insured Employees?

Wiley Rein LLP on

In February 2024, a group representing (among others) the Johnson & Johnson Group Health Plan and its component plans (Plaintiffs) sued Johnson & Johnson and The Pension & Benefits Committee of Johnson and Johnson (J&J) over...more

Stevens & Lee

FTC Files Suit Against the Three Largest Pharmacy Benefit Managers

Stevens & Lee on

The Federal Trade Commission (FTC) recently sued the three largest pharmacy benefit managers (PBMs) – Caremark Rx, Express Scripts (ESI) and OptumRx – alleging that the PBMs and their related group purchasing organizations...more

Mintz - Health Care Viewpoints

PBM Policy and Legislative Update - Winter 2024

The PBM regulatory landscape continues to evolve rapidly at both federal and state levels, making it critical for our clients involved in the PBM space to stay apprised of developments in the industry. Our team actively...more

Hogan Lovells

FTC and DOJ outline potential changes to agencies’ review of pharmaceutical mergers

Hogan Lovells on

On June 1, 2023, the Federal Trade Commission (FTC) and the Antitrust Division of the US Department of Justice (DOJ) released a summary of a workshop jointly held by the agencies in June 2022 titled “Future of...more

Morrison & Foerster LLP

Coming Soon: Revived FTC Robinson-Patman Act Enforcement

After decades of dormancy, enforcement of the Robinson-Patman Act may be making a comeback. In his first public remarks as an FTC Commissioner regarding his views on antitrust enforcement, Commissioner Alvaro Bedoya called...more

Patterson Belknap Webb & Tyler LLP

Tenth Circuit Upholds Pharmaceutical Company’s Exclusive Rebate Agreements in In re EpiPen

The Tenth Circuit recently became the first federal court of appeals to address an antitrust challenge to a relationship central to modern pharmaceutical drug markets:  the price negotiations between drug companies and...more

Faegre Drinker Biddle & Reath LLP

FTC Issues Policy Statement Putting PBMs on Notice

On June 16, 2022, the FTC unanimously voted to issue an enforcement policy statement putting Pharmacy Benefit Managers (PBMs) on notice that the payment of rebates and fees by drug manufacturers to PBMs resulting in the...more

Mintz - Antitrust Viewpoints

DOJ and FTC Virtual Workshop: Agencies Discuss Novel Approaches to Address Competition Issues in Pharmaceutical Mergers

On June 14 and 15, 2022, the Department of Justice Antitrust Division (“DOJ”) and the Federal Trade Commission (“FTC”) hosted a virtual workshop to discuss antitrust analysis of pharmaceutical mergers and anticipated focal...more

Tarter Krinsky & Drogin LLP

The Federal Trade Commission Launches Investigation into Pharmacy Benefit Managers

The Federal Trade Commission (FTC) has launched an inquiry into the largest Pharmacy Benefit Managers (PBMs) in the United States, with the goal of scrutinizing the PBMs’ practices and influence on the pharmaceutical...more

Akerman LLP - Health Law Rx

Long Delayed CVS/Aetna Merger Finally Gains Court Approval

Concluding one of the longest merger reviews in history, on September 4, Judge Richard Leon, District Judge for the District of Columbia, issued his final ruling in United States v. CVS Health, approving the proposed...more

Orrick - Antitrust Watch

Toward Uncharted Waters – The CVS-Aetna Merger

On June 4 – 5, 2019, Judge Richard J. Leon of the U.S. District Court for the District of Columbia held an extraordinary and unprecedented evidentiary hearing to decide whether to enter the proposed Final Judgment in U.S. v....more

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