Senators Press FTC to Finalize Pharmacy Benefit Manager Study

Sens. Chuck Grassley and Maria Cantwell have asked the Federal Trade Commission (FTC) to finish its long-running Section 6(b) study of pharmacy benefit manager (PBM) business practices and publish a final report with recommendations to Congress. Opened in June 2022, the study examines a segment of the prescription-drug market that affects how pharmacy benefits are administered and how patients, pharmacies, plan sponsors, and taxpayers interact with drug pricing and access. The senators’ request is an oversight action, not a solicitation, contract award, or new funding announcement.

The FTC has issued interim staff reports in July 2024 and January 2025, but has not completed the study. Grassley and Cantwell said the interim findings describe how concentration and vertical integration in the PBM industry may give leading firms the ability and incentive to increase drug costs, steer patients toward more expensive drug options, and operate with limited transparency. They argued that interim reporting and proposed consent agreements do not provide the comprehensive assessment Congress needs to evaluate the market and determine whether existing law is sufficient.

The senators also praised the FTC’s efforts to secure proposed consent agreements with Express Scripts and Caremark, while emphasizing that further action is needed to hold PBMs accountable and lower prescription costs. They said Congress needs a final report to assess whether antitrust and consumer protection laws adequately address the conduct identified in the interim reports and whether additional legislation is warranted. The request follows bipartisan congressional attention to the study, including letters led by Grassley and Cantwell in 2022 and January 2024 urging the FTC to complete its investigation.

For GovCon organizations, the immediate signal is limited: the request identifies no new contract, funding, compliance requirement, procurement deadline, or agency buying activity. However, the final report could inform future legislative or regulatory changes affecting prescription-drug markets. Pharmacy benefit managers, health-plan administrators, agencies and other plan sponsors that procure prescription-drug services should monitor the study’s conclusions for potential effects on market structure, transparency, patient access, and assumptions embedded in benefits contracting. Any procurement impact remains contingent on subsequent congressional or regulatory action.

• Action requested: Grassley and Cantwell are urging the FTC to complete its Section 6(b) PBM study and release a final report with recommendations to Congress.
• Study timeline: The investigation began in June 2022; FTC interim staff reports were issued in July 2024 and January 2025.
• Issues raised: The senators cited interim findings on industry concentration, vertical integration, potential drug-cost increases, steering toward more expensive options, and limited transparency.
• Companies identified: The senators recognized proposed FTC consent agreements involving Express Scripts and Caremark; the source does not report finalized agreements.
• Congressional purpose: A final assessment would help lawmakers evaluate whether existing antitrust and consumer protection laws address the conduct and whether additional legislation is warranted.
• Stakeholders: The senators identified Congress, taxpayers, plan sponsors, patients, and pharmacies as audiences that could benefit from clearer information about competitive conditions.
• Procurement outlook: No solicitation, award, funding, new compliance mandate, or procurement deadline is announced; there is no immediate action for agencies or contractors.
• Actionable monitoring: PBMs and organizations procuring prescription-drug services should track the final report and any subsequent legislative or regulatory proposals for changes to market conditions or contracting assumptions.