FTC Will Investigate Anti-Competitive Rebating But Any Enforcement Action Would Take Time
Commission policy statement highlights situations where rebates lead to formulary exclusion of lower-priced insulin. But concern is also relevant for other drug classes, including highly-anticipated coverage decisions for biosimilars to Humira.
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For biopharma manufacturers, chipping away at the rebate rule is a relatively painless drug pricing “pay for” compared to price control policies.
Study will examine how the six largest pharmacy benefit managers in the US handle 10 disease categories. Federal Trade Commissioners unanimously support inquiry after its scope was broadened from an earlier version that drew objections from Republicans.
According to a report commissioned by PhRMA, the three largest pharmacy benefit managers continue to exclude more drugs from standard formularies, including those with expedited FDA approval.