FTC says Optum, other prescription benefit managers inflate cancer drug prices 1,000%

(FOX 9) - The Federal Trade Commission says just three big companies control 80 percent of prescription drug pricing. Minnesota-based Optum RX, CVS Caremark and Express Scripts are now accused of marking up prices.

Prescription benefit managers have been under growing scrutiny from state and federal regulators who have accused them of creating pharmacy deserts by steering consumers to their own pharmacies and driving independent pharmacists out of business.

What we know:

The FTC released a study on Tuesday that outlined what it called a "growing profit center" for PBMs like Minnesota-based Optum RX. The report shows those companies increase the reimbursement rates to their own pharmacies for many specialty drugs by "hundreds and thousands of percent."

Reimbursement rates for drugs used to help transplant patients and treat HIV were marked up more than 100-percent, according to the FTC. Other drugs that treat cancer, multiple sclerosis and hypertension had reimbursement rates that were marked up more than 1,000 percent.

Companies accused of inflating drug prices 100% to 1,000%

The backstory:

Pharmacy benefit managers are supposed to operate as middlemen that help negotiate drug prices down.

But FOX 9 recently found that PBMs are under growing scrutiny because they are under the same ownership umbrella as large insurance companies and pharmacy chains. The companies are accused of creating "pharmacy deserts" by steering consumers to their own pharmacies and driving independent pharmacists out of business.

In July, the Federal Trade Commission found "these powerful middlemen may be inflating drug costs" and "squeezing main street pharmacies."

What they're saying:

On Tuesday, pharmacists from across the country accused PBMs of driving up profits for their own pharmacies while driving smaller pharmacists out of the industry.

One pharmacist testified that she recently resorted to selling her own baked goods to stay in business, saying her margins are higher on a cup of coffee.

Pharmacists in Minnesota recently told FOX 9 that PBMs control everything.

"The big three control who I can fill prescriptions for, what prescription I can fill, how often I can fill them and what I’m going to get paid for it," Debroah Keaveny said.

Keaveny has joined a class action lawsuit against PBMs and is advocating for new legislation at the state and federal level.

The other side:

In statements to FOX 9, OptumRx insists they are lowering the cost of specialty medications.   Express Scripts says the FTC report narrowly focuses on just a few drugs.  CVS Caremark has not yet responded to our request for comment.