Signage is seen at the Federal Trade Commission headquarters in Washington, D.C., U.S., August 29, 2020.
Signage is seen at the Federal Trade Commission headquarters in Washington, D.C., U.S., August 29, 2020. Reuters / Andrew Kelly

The U.S. Federal Trade Commission said on Thursday it was seeking public comment on how pharmacy benefit managers (PBMs) affect smaller pharmacies and consumers, after commissioners could not agree this month on whether to approve a study of the plans.

The request for comment includes questions around the impact of PBM rebates and fees on drug prices, whether patients are forced to substitute drugs in order to maximize PBM rebates and fees, conflicts of interest and other issues.

The agency said in a statement that it was inviting public comment on the big PBMs, which include CVS Caremark, UnitedHealth Group Inc's OptumRx and Cigna Corp's Express Scripts.

FTC Chair Lina Khan failed to win needed Republican support last week for an indepth study of PBMs, which serve as intermediaries between drug manufacturers, health insurance plans and pharmacies to negotiate prescription drug prices. The two Democrats on the commission voted yes while the two Republicans voted no. A tie vote means the study cannot go forward.