From List Prices to Net Prices
“For years, out-of-pocket costs for patients were driven by artificially high list prices and convoluted rebate games,” FTC Chairman Andrew Ferguson wrote in a post on X. “That ends with this settlement. Now, out-of-pocket costs for American patients will now be set by net drug prices.”
In essence, the settlement shifts the benchmark for what patients pay. Instead of calculating costs based on inflated list prices, the framework would tie out-of-pocket expenses to net prices — the amounts after rebates and discounts are accounted for.
A Narrow Vote at the Commission
The decision to approve the settlement came from a sharply divided and diminished commission. With Commissioner Mark Meador recused, Ferguson cast the sole vote in favor of the deal. The FTC currently operates with only two members, both Republicans.
The settlement removes Express Scripts from the agency’s ongoing administrative case but leaves Caremark Rx and OptumRx still facing allegations that they participated in rebate practices that pushed insulin prices higher.
