Pharmacy Benefit Manager Reaches Settlement with FTC Requiring Change…

The FTC settled its antitrust case against Caremark (one of three largest PBMs controlling 80% of US prescriptions), requiring structural changes to drug pricing, rebate pass-through to patients, insulin cost caps, and prohibition of hub pharmacies. The settlement estimates $8.5bn in consumer savings over 10 years, with Express Scripts having settled in February 2026 and Optum's case pending. If you supply drugs, pharmacies, or patient assistance services, the rules around PBM rebates and formulary access just changed—and the three largest PBMs have now accepted structural changes that will reshape how they negotiate with you. Rebates that were quietly retained are now flowing to patients; the middleman's ability to lock you out of formularies based on pricing just got constrained.