NCPA Cites Litany of PBM Abuses at FTC Hearing

“PBMs use their size and gatekeeper position to tilt the playing field,” says the National Community Pharmacists Association

NCPA February 17, 2022

Alexandria, VA (February 17, 2022) – Huge claw-backs, patient steering, under-water reimbursements, mafia-style contracts. NCPA didn’t pull any punches today at an FTC hearing on whether the agency should order PBMs to hand over reams of information about their anti-competitive practices.

“NCPA has been very vocal in our concerns about how PBMs vertically integrated upstream with Aetna, Cigna, UnitedHealth and the Blues and downstream with pharmacies, have exploited their data platforms to engage in myriad unfair methods of competition against pharmacy competitors which result in increased costs to patients,” said NCPA General Counsel Matt Seiler. NCPA, which represents more than 19,000 small-business pharmacies, all independently owned, has been the most persistent and determined advocate in the industry in calling on the FTC to pry open the PBMs.

The commissioners heard testimony this afternoon on a proposal to study PBM practices, with a tight focus on how they affect independent community pharmacies. NCPA has called on the FTC for just such an investigation multiple times in the past year, most recently in letters to Chairwoman Lina Khan in December and February. If the commissioners approve the study today, PBMs will have to cooperate or face penalties. A vote is expected later this afternoon.

“These methods include contract terms that restrict access to patients; massive claw backs in the form of DIR and GER fees; patient steering away from community pharmacies; below-cost reimbursements; and punitive audit practices. We encourage you to vote yes today to study these practices to bring transparency where none currently exists,” said Seiler.

Click here for more information on NCPA’s outreach to the FTC. For more information about NCPA, please visit


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit