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The FTC sued UnitedHealth Group's Optum unit, CVS Caremark and Cigna's Express Scripts for allegedly steering diabetes patients towards higher priced insulin.
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2] Express Scripts had 2016 revenues of $100.752 billion. [2]
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
This Optum-UnitedHealth model of vertical integration [20] is pointed to as having sparked a pattern of acquisition activity in the healthcare industry; most notably, mega-mergers between CVS-Aetna, Cigna-Express Scripts and Humana-Kindred. [21] "Optum's been the leader in showing how a managed care organization with an ambulatory care delivery ...
The case accuses UnitedHealth Group Inc's Optum unit, CVS Health Corp's CVS Caremark and Cigna Corp's Express Scripts of unfairly excluding lower cost insulin products from lists of drugs covered ...
The three biggest PBMs are UnitedHealth Group Inc's Optum unit, CVS Health Corp's CVS Caremark and Express Scripts. (Reporting by Susan Heavey in Washington and Jody Godoy in New York; editing by ...