Cigna’s PBM unit launches new pricing plan amid scrutiny over rebates

Cigna’s PBM unit launches new pricing plan amid scrutiny over rebates

https://www.reuters.com/business/healthcare-pharmaceuticals/cignas-pbm-unit-launches-new-pricing-plan-amid-scrutiny-over-rebates-2023-04-13/

April 13 (Reuters) – Cigna Group’s (CI.N) pharmacy benefit management (PBM) unit said on Thursday it will launch a new pricing plan that will include exact information on rebates, as pharmacy middlemen come under scrutiny by U.S. lawmakers for their opaque drug pricing practices.

The new plans from Cigna come amid close examination from regulators including the U.S. Federal Trade Commission which is conducting a study to see if rebates sought by pharmacy middlemen reduced competition, ultimately leading to higher drug prices.

The PBM unit, Express Scripts, will also introduce a new co-pay plan for consumers which will cap out-of-pocket costs between $5 and $45, depending on whether the drug is generic or branded.

PBMs negotiate drug prices with manufacturers, health plans and pharmacies.

Last month, Ohio filed a lawsuit alleging PBM units of Cigna Group, Humana Inc (HUM.N) and others use their market power to push drug companies to increase prices, some of which goes to PBMs in the form of fees.

Express Scripts said under the new pricing plan its clients will “receive 100% of drug rebates” that are paid to it by drug manufacturers. The pricing and co-pay plans will be launched this summer.

Next year, Express Scripts will begin including information on drug prices and out-of-pocket costs as part of its prescriptions for consumers.

Express Scripts, UnitedHealth Group Inc’s (UNH.N) Optum unit and CVS Health Corp’s (CVS.N) CVS Caremark are among the biggest PBMs in the United States.

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