The Federal Trade Commission (FTC) is preparing to sue the three largest pharmacy benefit managers (PBMs) – CVS Health, Cigna, and UnitedHealth Group. The FTC accuses these PBMs of raising patients’ costs and driving pharmacies out of business by trading rebates for favored positioning of brand-name insulin over cheaper biosimilars. This move is part of a broader investigation into the practices of pharmacy middlemen, with a recent FTC 6(b) Interim Staff Report highlighting significant concerns. On April 22nd, it was reported that the FTC was preparing this lawsuit.