CVS Caremark settles FTC case over drug rebates and TrumpRx deductible credits
CVS Health's Caremark reaches a settlement with the U.S. Federal Trade Commission that targets rebate practices in the pharmacy benefits market. The agreement also requires the company to count eligible TrumpRx drug purchases toward some insurance deductibles once supporting regulations are in place.
Highlights
- CVS Caremark will allow clients to opt out of rebate-based payment models and curb after-market drug rebate practices under the recent FTC settlement.
- The settlement requires CVS to count patients' TrumpRx website payments toward deductibles on some health plans, pending new regulations.
- FTC Chairman Andrew Ferguson states the changes are expected to generate billions of dollars in drug price savings for consumers.
Settlement terms and program scope
As reported by Reuters, citing the U.S. Federal Trade Commission, the settlement requires CVS Caremark to curb its use of after-market drug rebates and to offer clients an option to opt out of rebate-based payment models.The deal mirrors a settlement the FTC reaches with Cigna earlier this year and addresses practices that critics say keep drug costs high. An FTC spokesperson says CVS' pharmacy benefit manager must also include a patient's payments through the TrumpRx drug website toward deductibles in some health plans, once regulations are established to support the program.
These rebates are paid by drugmakers to pharmacy benefit managers after a drug is dispensed and may or may not be passed on to plan sponsors or consumers. The settlement is expected to bring billions of dollars in drug price savings, FTC Chairman Andrew Ferguson says in a statement.
Implications for consumers and the drug benefits market
TrumpRx.gov launches in February under U.S. President Donald Trump as a discount platform for hundreds of generic and branded medicines, with a particular focus on popular weight-loss drugs from Eli Lilly and Novo Nordisk.Because the website sends cash-paying customers to drugmaker sites for discounted medicines and operates outside insurance coverage, its usefulness has been limited for some consumers. By allowing eligible purchases to count toward deductibles, the settlement could make those discounts more meaningful for patients who need to meet minimum out-of-pocket spending before insurance coverage applies.
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