Scathing FTC Interim Report on PBMs Warrants Further Investigations, Immediate Action by Policymakers and Regulators

Investigation confirms massive middlemen employ tactics like steering, inflated costs, low reimbursements, harmful contractual terms, etc., that hurt patients and independent pharmacies

NCPA July 9, 2024

ALEXANDRIA, Va. (July 9, 2024) – The interim report published today by the Federal Trade Commission – titled “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies” – should leave no doubt that these massive health care conglomerates are creating unfair advantages for themselves that are driving up costs for consumers, limiting consumer choices, and killing access to quality pharmacy care, the National Community Pharmacists Association says.  

“The report finds that PBMs wield enormous power over patients’ ability to access and afford their prescription drugs, allowing PBMs to significantly influence what drugs are available and at what price,” says the FTC’s news release. Additionally, it says, the agency “finds that PBMs hold substantial influence over independent pharmacies by imposing unfair, arbitrary, and harmful contractual terms that can impact independent pharmacies’ ability to stay in business and serve their communities.”

In a statement, NCPA CEO B. Douglas Hoey, pharmacist, MBA, praises the FTC’s findings thus far, also reiterating the need for further investigation into PBM-insurers and definitive action to rein them in. Hoey says:

“In recent years, the pharmacy benefits space has undergone massive transformation. It’s no longer 2005. Without question – and as the interim report makes clear – the marketplace has exploded because of countless mergers and acquisitions as well as tactics like patient steering and take-it-or-leave-it contracting. It’s a system that may work for massive PBM middlemen, but it’s anti-consumer and anticompetitive.  

“It has been abundantly clear for years that policymakers must level the playing field. Congress must swiftly enact reforms to rein them in, and states should continue doing so as well. Regulators at all levels must keep a close eye on these entities and enforce the laws that are on the books. And the FTC must continue its investigation and pursue the information that the PBMs have so far defiantly withheld. Patients and community pharmacies need this fight to be finished, and need it urgently.”

The interim report is part of an ongoing inquiry the FTC launched in 2022, during which the agency received more than 24,000 comments from the public – including independent pharmacists – about anticompetitive contracts and how PBM practices affect consumers.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 19,400 pharmacies that employ more than 230,000 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