The three largest pharmacy benefit managers are looking to take their legal back-and-forth with the Federal Trade Commission (FTC) to the 8th Circuit Court, according to a court filing issued late last week.
CVS Health's Caremark, Cigna's Express Scripts and UnitedHealth's Optum Rx filed a notice of appeal Friday after a Missouri District Court determined that the FTC's case could move ahead. The agency filed suit against the so-called "Big Three" in September, alleging they played a key role in inflating the price of insulin.
The PBMs hit back with a countersuit in November, arguing the FTC's actions were unconstitutional.
The Missouri court declined to give the companies the preliminary injunction they sought, saying precedent makes the case unlikely to be successful.
The District Court also questioned whether it had jurisdiction to weigh in on the case and whether the three PBMs were likely to feel the harms that they claim. However, the judge did say it's plausible they could ultimately prevail in some way even through the lower courts did not approve an injunction.
"This denial of preliminary relief does not mean that Plaintiffs will be unable to obtain any relief when all is said and done," the courts wrote.
The FTC has been scrutinizing the pharmacy benefit management industry since 2022, asking six of the industry's largest players to report key details on their business practices. Last summer, the agency released a report that argued PBMs engage in practices that likely warrant further investigation and potential regulation.
While the FTC did not take action against drugmakers in the September lawsuit, the agency did put those companies on notice for their role in insulin pricing.