The U.S. Federal Trade Commission and CVS Health's Caremark unit have finalized a settlement that places new limits on how the pharmacy benefits manager can use after-market discounts, commonly known as rebates, and requires that patient purchases made via the TrumpRx drug website be applied to certain health plan deductibles.
Under the terms of the agreement, Caremark will reduce its reliance on rebates as a component of its pharmacy benefit operations. The settlement also mandates that, once the regulatory framework for the TrumpRx program is established, payments made by consumers through that platform must be counted toward the deductible requirements of some health plans administered by Caremark.
The FTC described the settlement as comparable to an earlier pact it reached with Cigna earlier this year. Both settlements address practices the agency and critics argue can contribute to higher out-of-pocket drug costs for consumers.
FTC Chairman Andrew Ferguson said the settlement is expected to produce billions of dollars in savings on drug prices. He emphasized that the FTC, under the current administration, will not permit anticompetitive behavior that increases prices for American consumers.
TrumpRx.gov, launched in February, is a federal platform that directs cash-paying customers to drugmaker websites offering discounted generic and branded medications. The service focuses in part on facilitating lower-priced options for widely used weight-loss drugs produced by Eli Lilly and Novo Nordisk.
At present, the TrumpRx offering operates outside insurance coverage. That structure has limited its usefulness for some consumers whose insurance benefits do not begin until deductibles have been met. The settlement aims to address that limitation by ensuring payments through TrumpRx will, when implementing regulations permit, count toward the deductible thresholds of applicable health plans managed by Caremark.
Context and implications
- The agreement aligns Caremark with an earlier FTC settlement involving another large PBM, reflecting a regulatory focus on rebate practices.
- Requiring TrumpRx payments to count toward deductibles could make the platform more usable for insured consumers, pending regulatory implementation.
- The FTC projects substantial savings from the settlement, though the precise impact on prices and PBM business practices will depend on forthcoming regulations and implementation details.