Part of the Insurance claim playbook.
FTC Settles Antitrust Case Against Caremark, One of the Nation's Largest PBMs
The Federal Trade Commission has reached a settlement agreement with Caremark and its affiliated entities, resolving an antitrust enforcement action against the pharmacy benefit manager. The settlement is designed to lower patients' out-of-pocket drug costs, improve pricing transparency, and require fairer treatment of community pharmacies.
What this means for you
Consumers in this situation — paying retail drug prices set through PBM contracts — may see changes at the pharmacy counter if the settlement's requirements take effect as intended. PBM settlements that mandate transparency and restrict certain pricing practices have historically created new disclosure rights for patients and independent pharmacies alike. People who use community pharmacies or who pay high out-of-pocket costs for prescription drugs are the group most likely to be affected by these types of structural changes. Watching for updated plan disclosures from your insurer or pharmacy benefit plan can be a useful way to track whether those changes reach you.
The facts
- The FTC announced a settlement with Caremark and its affiliated entities on July 14, 2026, resolving an antitrust enforcement action the agency had brought against the company.per the FTC press release · as of July 14, 2026
- The FTC's enforcement action charged Caremark — which the agency identified in its complaint as one of the nation's largest pharmacy benefit managers — with antitrust violations related to drug pricing and pharmacy treatment.according to the FTC complaint and settlement announcement · as of July 14, 2026
- The settlement is intended to drive down patients' out-of-pocket prescription costs and ensure community pharmacies are treated fairly under PBM contracting practices.per the FTC press release · as of July 14, 2026
- The FTC described the resolution as its second major enforcement action against a large PBM, framing it as part of a broader agency effort to reduce healthcare costs for American consumers.according to the FTC press release · as of July 14, 2026
What you can do
Keeping dated records of your prescription receipts and explanation-of-benefits statements makes it easier to spot changes in what you are charged over time. If you believe you have been overcharged or denied a fair price, filing a complaint with the FTC at reportfraud.ftc.gov creates an official record. Asking your pharmacist or insurer directly about any new transparency disclosures required by regulatory settlements is a practical first step.
Common questions
What did the FTC's settlement with Caremark require?
The FTC's settlement with Caremark, announced July 14, 2026, resolves antitrust charges the agency brought against the pharmacy benefit manager. Under the consent order, the FTC alleges the agreement is designed to lower patients' out-of-pocket drug costs, increase pricing transparency, and require fairer treatment of community pharmacies under the contracting practices cited in the complaint.
What is a pharmacy benefit manager and why is the FTC targeting them?
Pharmacy benefit managers, or PBMs, are middlemen that negotiate drug prices between insurers, drug manufacturers, and pharmacies. The FTC has brought antitrust enforcement actions against large PBMs, alleging that certain pricing and contracting practices harm consumers and squeeze out community pharmacies. The Caremark settlement is the second such major action the FTC has announced.