How have the FTC's PBM settlements resolved the case?
Express Scripts settled in February 2026; Caremark in July 2026 — requiring point-of-sale rebate pass-through, an end to formulary discrimination and insulin affordability programmes — with the FTC projecting up to $8.5 billion in consumer savings over ten years.
Express Scripts settled first, in February 2026, agreeing to reforms intended to gouging/" target="_blank" rel="noopener noreferrer" class="article-link">delink PBM compensation from list prices and base patient cost-sharing on net prices. Caremark followed; the FTC announced its settlement in July 2026, requiring it to stop discriminating against low-cost versions on formularies, pass rebates to patients at the point of sale, and create insulin affordability programmes. The FTC projects up to $8.5 billion in consumer savings over ten years, plus $4.5 billion through point-of-sale rebates. The case against OptumRx was withdrawn from adjudication to consider a proposed consent agreement. Patient advocates welcomed the reforms but stressed that manufacturers raised prices in lockstep too and must also be held accountable.