Tables begin to turn on PBM after years of squeezing consumers, employers, and independent pharmacie...


Alexandria, Va., Feb.  04, 2026  (GLOBE NEWSWIRE) --  The National Community Pharmacists Association cheered an announcement by the Federal Trade Commission today that insurance giant Cigna has agreed to make big concessions to help remedy years of unfair business practices that have plagued consumers with higher drug prices and hurt independent pharmacies by stifling competition.   “This settlement will help lower consumers’ copays that have been tied to artificially inflated prices that feed Cigna’s insatiable appetite for more and more rebates and GPO fees,” said NCPA CEO B. Douglas Hoey. “The settlement also obliterates the big-PBM industry fiction that they work to lower the cost of drugs for Americans. Obviously, the opposite appears to be true. I hope this is only the beginning of righting the games leading to higher drug prices and harming competition. There remains a need for a deep look into specialty drug classification and steering, and the Express Scripts Prime Therapeutics so-called collaboration, to name a few.”   The settlement comes after years of meetings between NCPA and FTC staff, during which NCPA’s legal team educated government lawyers on the many egregious PBM practices that squash competition, reduce patient access, and drive up prices.   “NCPA has for some time witnessed the anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin and other drugs, which have hurt American pocketbooks. Employers should take note, too, of what the FTC has accomplished here and wake up to the fact that this settlement proves that for years, Cigna's Express Scripts drug pricing and reimbursement opacity may have caused them significant financial harm,” said NCPA General Counsel Matt Seiler. “While more work needs to be done to ensure adequate dispensing fees and sustainable Medicaid, Medicare, and Tricare drug pricing and reimbursement, this settlement is a huge step in the right direction for America.”     The settlement requires Cigna’s Express Scripts to eliminate spread pricing, decouple rebates and fees from the list price of drugs, requires Cigna’s GPO, Ascent to relocate from Switzerland to the U.S., and submit to FTC monitoring for 10 years. It also forces the company to adopt a cost-plus model for independent pharmacy reimbursement (three pharmacies or fewer) in commercial plans starting in 2027 or sooner.   “The cost-plus model element is very important,” said Hoey. “We don’t yet know the details, but it’s critical that pharmacies are reimbursed at a level that covers their cost of acquiring, dispensing, and monitoring medicines and leaves them with a reasonable profit. The big insurers and their PBMs are notorious for reimbursing pharmacies at rates below their operating costs, which causes them to lose money and ultimately go out of business. We look forward to more details on this element of the agreement.”   Hoey noted that below-cost pharmacy reimbursements are the main driver behind pharmacy deserts, which are areas in the country where pharmacies have disappeared and patients are stranded without a local health care provider. Adequate reimbursements, he said, ensure healthy competition and, therefore, more choices for patients. He also encouraged employers to demand more from the brokers they hire to help them select drug benefit plans for their employees, because a healthy workforce depends on accessible pharmacies and lower drug costs.   To view the FTC news release announcing the settlement, click here.   ###   Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 18,900 pharmacies that employ more than 235,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America's most accessible health care providers. To learn more, visit www.ncpa.org.  
            

Boom! FTC Squeezes Concessions from Cigna's Express Scripts

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  <section data-block="information">
    <h3>Information</h3>
    <p>Tables begin to turn on PBM after years of squeezing consumers, employers, and independent pharmacie...</p>
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  <section data-block="ai-summary-paragraph">
    <h3>AI Summary</h3>
    <p>Cigna has agreed to significant concessions following an FTC settlement to address unfair pricing practices, aiming to reduce drug costs for consumers and restore competition among pharmacies. The mandate for a cost-plus reimbursement model beginning in 2027 could stabilize independent pharmacies and enhance patient access to essential medications.</p>
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  <section data-block="ai-summary-bullets">
    <h3>Key Points</h3>
    <ul><li>Cigna agrees to concessions to address unfair pricing practices.</li><li>Settlement aims to reduce consumers&#039; copays on drugs.</li><li>Cigna will adopt a cost-plus model for independent pharmacies.</li><li>FTC monitoring required for 10 years post-settlement.</li><li>Settlement may enhance competition in the pharmacy market.</li></ul>
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  <section data-block="companies-mentioned">
    <h3>Companies Mentioned</h3>
    <ul><li><strong>Cigna (CI)</strong>: Settlement may impact CI&#039;s pricing strategy and competitive stance.</li><li><strong>Express Scripts (part of CI)</strong>: Transforming pricing model can enhance operational transparency.</li><li><strong>Ascent (part of CI)</strong>: Relocation to the U.S. may increase regulatory scrutiny on operations.</li></ul>
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    <h3>Corporate Developments</h3>
    <p>This news falls under &#039;Corporate Developments&#039; due to the significant regulatory changes impacting Cigna&#039;s operational framework and market strategy. It signals a transformative approach that could reshape the pharmacy benefits landscape, hence impacting investor sentiment and performance.</p>
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  <section data-block="market-moving">
    <h3>Market-Moving</h3>
    <ul><li>Approval of the settlement may enhance Cigna&#039;s competitive positioning in the pharmacy space.</li><li>Increased transparency in drug pricing could lead to higher market trust.</li><li>The new reimbursement model could impact Cigna&#039;s profit margins positively in the long run.</li><li>Regulatory scrutiny on PBM practices may expand further, affecting Cigna&#039;s operating model.</li></ul>
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  <section data-block="key-facts">
    <h3>Key Facts</h3>
    <ul><li>The settlement addresses years of unfair practices affecting drug pricing.</li><li>Cigna&#039;s Express Scripts must eliminate spread pricing and decouple rebates by 2027.</li><li>FTC will monitor Cigna&#039;s compliance for the next 10 years.</li><li>Cigna must adopt a cost-plus model for small pharmacies starting in 2027.</li><li>The NCPA represents over 18,900 pharmacies nationwide.</li></ul>
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    <h3>Trading Thesis</h3>
    <p>CI is positioned for potential long-term gains due to regulatory changes enhancing pricing transparency.</p>
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<article>
    <h2>FTC Forces Cigna's Express Scripts to Make Major Concessions</h2>
    <p>On February 4, 2026, the Federal Trade Commission (FTC) announced that insurance giant <strong>Cigna</strong> has agreed to substantial concessions aimed at addressing years of unfair business practices. This settlement is expected to reduce drug prices for consumers and enhance competition for independent pharmacies.</p>

    <section>
        <h3>Details of the Settlement</h3>
        <p>The settlement follows extensive discussions between the National Community Pharmacists Association (NCPA) and FTC staff. The NCPA highlighted a series of practices employed by pharmacy benefit managers (PBMs) that have negatively impacted consumers by inflating drug costs and reducing access to medications.</p>
        <ul>
            <li>Cigna's Express Scripts will eliminate spread pricing.</li>
            <li>Rebates and fees must be decoupled from the list price of drugs.</li>
            <li>Cigna's group purchasing organization (GPO), Ascent, is required to relocate from Switzerland to the U.S.</li>
            <li>The company will be under FTC monitoring for a period of 10 years.</li>
            <li>A cost-plus reimbursement model for independent pharmacies will be implemented in commercial plans starting in 2027 or sooner.</li>
        </ul>
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    <section>
        <h3>Insights from Industry Leaders</h3>
        <p>NCPA CEO B. Douglas Hoey emphasized the significance of the settlement, stating, <em>"This settlement will help lower consumers’ copays that have been tied to artificially inflated prices that feed Cigna’s insatiable appetite for more and more rebates and GPO fees."</em> He criticized the prevailing notion that big PBMs work to lower drug costs for Americans, suggesting that they actually contribute to rising prices.</p>
        <p>Matt Seiler, NCPA General Counsel, expressed concern over existing practices, saying, <em>"NCPA has for some time witnessed the anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin and other drugs."</em> He encouraged employers to recognize how these practices may have financially harmed them over the years.</p>
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        <h3>Impact on Independent Pharmacies</h3>
        <p>The introduction of a cost-plus model for pharmacy reimbursements is crucial for the survival of many independent pharmacies. Hoey explained, <em>"It's critical that pharmacies are reimbursed at a level that covers their cost of acquiring, dispensing, and monitoring medicines and leaves them with a reasonable profit."</em> Below-cost reimbursements are a key factor contributing to the phenomenon of pharmacy deserts, leaving patients without local health care providers.</p>
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    <section>
        <h3>Encouragement for Employers</h3>
        <p>Hoey urged employers to demand better from their brokers when selecting drug benefit plans. He noted that a healthy workforce is reliant on accessible pharmacies and affordable drug costs. By ensuring fair reimbursement practices, employees will have more choices and better access to medications.</p>
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    <section>
        <h3>About NCPA</h3>
        <p>Founded in 1898, the National Community Pharmacists Association is the voice of community pharmacists, representing over 18,900 pharmacies that employ more than 235,000 individuals nationwide. For more information, please visit <a href="http://www.ncpa.org">www.ncpa.org</a>.</p>
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Cigna has agreed to significant concessions following an FTC settlement to address unfair pricing practices, aiming to reduce drug costs for consumers and restore competition among pharmacies. The mandate for a cost-plus reimbursement model beginning in 2027 could stabilize independent pharmacies and enhance patient access to essential medications.

Boom! FTC Squeezes Concessions from Cigna's Express Scripts

AI Summary

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Trading Thesis

Market-Moving

Key Facts

Companies Mentioned

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