UnitedHealthcare's drug dealing arm is, according to the government, massively marking up the cost of life-saving medications.
In a new report, the Federal Trade Commission is charging OptumRx, UHC's pharmacy benefit manager (PBM), with inflating the cost of "numerous specialty generic drugs... by thousands of percent, and many others by hundreds of percent."
Along with the PBMs associated with Cigna and CVS, Optum allegedly price gouged on drugs like matinib, the generic version of the leukemia medicine Gleevec, the prostate cancer drug abiraterone, and the HIV medicine lamivudine. The latter was marked up to quadruple of what the so-called "Big 3 PBMs" paid for it, the FTC found.
Overall, the "Big 3 PBMs" marked up a whopping 22 percent of all the specialized medications that the FTC analyzed.
The companies also, per the FTC, "paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually."
Translation: those markups made each company hundreds of millions of dollars at the expense of the cancer patients who needed them.
As damning as these price-hiking findings are, this isn't the first we're hearing of them.
In 2023, for example, the American Urology Association's UrolPract journal found that out-of-pocket costs for abiraterone, the prostate cancer drug, were shockingly high. Depending on insurance coverage, abiraterone can run patients between $1,379 to $13,274 per year.
While Optum obviously isn't the only company who participated in this outrageous price-gouging, the FTC report dropping just five weeks after UHC CEO Brian Thompson's murder — widely linked to suspect Luigi Mangione's poor experiences with healthcare and insurance — feels pretty on-the-nose.
Details remain thin about what Mangione experienced after suffering an injury that left him in debilitating back pain. In the wake of Thompson's assassination, however, people have taken to social media in droves to share their own experiences with being denied care — and as Forbes reported last month, UHC refuses claims more than any other insurer.
Though the FTC didn't mention Mangione or Thompson in this "interim report," the agency acknowledged that this update to the first version in July 2024 provides a "more comprehensive analysis of how the PBM respondents reimburse specialty generic drugs" after the companies in question seemed to drag their heels getting back to the agency.
Notably, this is not the FTC's final report on the matter — and when that one comes out, it could be even more of a bombshell.
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