The Federal Trade Commission (FTC) has announced a landmark settlement with Express Scripts, Inc. (ESI), one of the largest pharmacy benefit managers in the U.S. This settlement mandates ESI to implement substantial changes in its business practices, which are projected to reduce patients' out-of-pocket drug costs by up to $7 billion over the next decade.

The FTC's lawsuit against ESI accused the company of artificially inflating the list prices of insulin drugs through anticompetitive rebating practices, which limited patient access to more affordable options. The settlement is seen as a significant step towards fulfilling the Trump Administration's healthcare priorities, aiming to provide financial relief to patients reliant on ESI for essential medications.

FTC Chairman Andrew N. Ferguson emphasized that the settlement will end practices that have kept drug prices high, benefiting both patients and community pharmacies. The agreement includes provisions for increased transparency, compliance with price transparency laws, and the reshoring of ESI's business operations to the U.S.

Under the consent order, ESI has agreed to several commitments, including ensuring that patients' out-of-pocket expenses are based on net drug costs rather than inflated list prices, and providing full access to its Patient Assurance Program for insulin benefits. The settlement also aims to promote a fairer pricing model for community pharmacies and enhance transparency for plan sponsors.

The public will have 30 days to comment on the proposed consent agreement, which, once finalized, will carry the force of law for future actions.