The Federal Trade Commission (FTC) may be nearing settlements with the remaining two pharmacy benefit managers involved in a lawsuit over insulin pricing.
In a court filing (PDF) posted this week, the agency disclosed that it is making "significant progress" in talks with both CVS Health's Caremark and UnitedHealth Group's Optum Rx on the heels of a broad settlement with Cigna's Express Scripts.
In late January, the FTC suspended the administrative case against Express Scripts, indicating a settlement was in the works. That settlement was later confirmed Feb. 4, with the PBM agreeing to a slew of changes to resolve allegations that it unlawfully and artificially inflated the price of insulin.
In the filing, the agency pushed back the date for an evidentiary hearing and oral arguments in the case by 21 days, to late March, to allow for greater negotiation time.
"This extension of the stay will provide time for the parties to further advance these discussions and determine whether there is an opportunity to resolve this proceeding," according to the document.
If the current schedule stands, the stay in the case will end March 23, with the evidentiary hearing pushed back to Aug. 20. Oral arguments on the PBMs' motion to dismissed the case are now set for March 31, per the filing.
Should a settlement not be reached, the commission has now set the deadline for a ruling on that motion to May 25.
A spokesperson for CVS said the company is "engaged in good-faith negotiations with the FTC, aimed at avoiding any prolonged litigation so that CVS Caremark can keep its focus on what it does best: making prescription drugs more affordable for Americans." They declined to offer further details on the discussions.
A spokesperson for UnitedHealth declined to comment on the discussions.
In its settlement, Express Scripts agreed that it would not list drugs in its formularies at the high wholesale acquisition cost and will instead opt for lower-cost options on its standard formularies. The PBM also said it will include the direct-to-consumer TrumpRx platform as part of its standard offerings.
In addition, Express Scripts said it would offer a standard benefit offering that will allow plan sponsors to move away from traditional rebates or spread pricing models, as well as a standard benefit where out-of-pocket expenses are based on the net price, rather than the list price, of a drug.
The FTC's original lawsuit alleged that these firms, which make up the "Big Three" in the PBM industry, artificially inflated the price of insulin by preferring rebates. Under this model, insulin manufacturers would compete for formulary placement based on the rebates rather than net price.
The court filings didn't offer any additional details on what a settlement with Optum or Caremark could look like.