NCPA Urges FTC to Narrow Broad Waiver of Liability, Protect Independent Pharmacies from Competitively Sensitive Data Disclosures

ALEXANDRIA, Va. (Sept. 2, 2026) – The National Community Pharmacists Association yesterday filed public comments with the Federal Trade Commission urging the agency to revise and strengthen its proposed consent order with Caremark Rx, LLC and Zinc Health Services LLC before granting final approval in Docket No. 9437.

NCPA supports meaningful relief that addresses pharmacy benefit managers’ rebate practices that inflate insulin list prices and harm patients. However, the association cautioned that the agency’s proposed settlement with Caremark and Zinc Health Services could impose serious unintended consequences on independent pharmacies if the FTC does not narrow its broad waiver of liability, strengthen data protections, and clarify how the order will preserve enforcement authority over non-insulin PBM conduct.

“The FTC’s insulin case is important, but the settlement should not become a vehicle for giving PBMs broader immunity, weakening future enforcement, or creating new opportunities for misuse of pharmacy-level data,” said Matthew Seiler, senior vice president and general counsel of NCPA. “Independent pharmacies should not be forced to disclose competitively sensitive acquisition-cost information to vertically integrated PBMs that also own their direct competitors just to obtain allegedly fair reimbursement, especially when the proposed data protections are plainly inadequate.”

In its comments, NCPA explains that while the proposed order appears to offer improved reimbursement terms for independent pharmacies, it conditions those terms on disclosure of actual acquisition cost information. Actual acquisition cost information is often not available on the individual transaction level due to rebates being applied at the end of the year and in the aggregate. Furthermore, NCPA warns that this information can reveal a pharmacy’s purchasing strategy, wholesaler relationships, margin structure, inventory economics, and ability to compete. Because Caremark is affiliated with CVS Health’s retail and mail-order pharmacy businesses, NCPA is urging the FTC to require stronger firewalls, limits on data use and retention, independent administration, and transparent alternatives such as publicly available benchmarks where appropriate.

NCPA also raises concerns that the proposed settlement could be treated as a de facto industry rule because substantially similar orders have been negotiated with the largest PBMs. The association urged the commission to ensure that any final order is narrowly tailored to the insulin-related claims actually alleged and remedied, and that it not release unrelated conduct involving pharmacy reimbursement, network restrictions, specialty pharmacy steering, audit practices, hub-pharmacy access, or other PBM practices affecting competition and patient access that both the FTC and Congress have identified as problematic.

The comments further ask the FTC to build a fuller public record before final approval, including an explanation of how the settlement relates to separate PBM investigations, congressional findings, civil investigative demands, and any claims the agency intends to release. NCPA emphasizes that federal and state enforcement authority must be preserved, particularly because independent pharmacies often face practical barriers to private enforcement, including arbitration provisions, confidentiality restrictions, high costs, unequal access to information, and potential network consequences.

“The commission can and should secure insulin-related relief without handing PBMs a litigation shield for unrelated conduct,” Seiler said. “Any final order should identify exactly what is being resolved, expressly preserve everything else, and make sure independent pharmacies are not forced to disclose sensitive business information to the very companies they compete against.”

NCPA’s comments request that the FTC prohibit respondents and their affiliates from receiving, using, retaining, or disclosing identifiable pharmacy-level acquisition-cost information absent a record-based finding that such disclosure is necessary, narrowly tailored, independently administered, firewalled, and subject to enforceable limits. The association also asks the agency to preserve claims involving non-insulin PBM conduct and clarify that the final orders do not limit federal, state, or private enforcement based on distinct products, services, markets, theories, time periods, or competitive effects.

For more than 125 years, NCPA has represented the interests of community pharmacists, including more than 18,900 pharmacies that employ over 235,000 individuals nationwide. Independent community pharmacies serve patients in rural, underserved, and medically vulnerable communities and compete directly with chain retail and mail-order pharmacies affiliated with the nation’s largest PBMs.

To read NCPA’s comments, click here.