Thursday, September 17, 2026Vol. XII · No. 214

Healthcare

Court dismisses PBMs’ lawsuit against FTC following insulin settlements

Express Scripts, Caremark and Optum Rx sued the FTC after the agency accused them of driving up the cost of insulin. But the countersuit is being put to bed now that the PBMs are settling.

Court dismisses PBMs’ lawsuit against FTC following insulin settlements
Wire / Centuries Mutual

Share Copy link Email LinkedIn X/Twitter Facebook Print Major pharmacy benefit managers’ countersuit against the Federal Trade Commission for accusing them of inflating the cost of insulin has been dismissed, after Express Scripts, Caremark and Optum Rx elected to settle with antitrust regulators over the allegations. The 8th Circuit Court of Appeals dismissed the lawsuit on Tuesday after both sides mutually decided to drop the litigation. Cigna’s Express Scripts, CVS’ Caremark and UnitedHealth’s Optum Rx had turned to the 8th Circuit in early 2025 after a district court declined to halt the FTC’s insulin pricing lawsuit against them. Express Scripts formally settled with the FTC over the allegations in February, while Caremark and Optum Rx agreed to proposed settlements in March and June, respectively. The FTC sued Express Scripts, Caremark and Optum Rx in late 2024,…

drug market, jointly controlling 80% of all the country’s prescriptions — vehemently denied the allegations, and quickly countersued. But in February 2025 the district court ruled the FTC’s case could move forward, sending the PBMs hustling to the 8th Circuit to plead for an injunction halting the suit. The 8th Circuit denied the PBMs’ request last March. And now, the appeals court is dismissing the countersuit altogether, one day after the parties filed a joint stipulation asking the court to end the case — a mechanism typically used when the opposing sides have reached a settlement. Express Scripts is the only company to have inked an official settlement. The deal is largely viewed as positive for the PBM, while addressing some of the FTC’s key concerns with the company’s business practices. It requires Express Scripts to delink its compensation from the savings it…


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