Democrats attack FTC settlements with PBMs

NCPA October 28, 2026

Congressional Democrats issued a report criticizing “weak antitrust enforcement and backroom deals” made under the current administration, including the Federal Trade Commission’s settlements with Express Scripts and CVS Caremark in enforcement actions over insulin price-gouging, saying that they would likely “not meaningfully lower Americans’ drug costs.” They pointed out that, while the settlements required the companies to lower insulin list prices and offer patients cheaper alternatives, they “imposed no fines, disgorgement of past profits, admissions of wrongdoing, or reimbursement to patients.” 

They also challenged the settlements’ requirement for the PBMs to offer direct-to-consumer pricing on TrumpRx, which the legislators said fails to deliver on promised lower pricing for prescription drugs. Finally, the report also noted the lack of action by the FTC to break up the vertically integrated giants that own CVS Caremark and Express Scripts. 

The report, which castigates the FTC and Department of Justice Antitrust Division for a wide array of antitrust settlements, merger approvals, and dismissals of enforcement actions, was released by Sens. Elizabeth Warren (D-Mass.), Mazie Hirono (D-Hawaii), and Richard Blumenthal (D-Conn.), and Reps. Becca Balint (D-Vt.), Pramila Jayapal (D-Wash.), and Jerry Nadler (D-N.Y.). 

Read Warren’s press release summarizing the report here, and the 54-page report itself here. 

NCPA