Cigna's Express Scripts Settles FTC Insulin Pricing Case, Agrees to Pricing Reforms (EXPS)

Cigna Corp's Express Scripts (EXPS) has settled the U.S. Federal Trade Commission's antitrust and consumer protection claims, agreeing to overhauling insulin and drug pricing practices to lower costs. The 10-year agreement, effective February 4, 2026, bans rebate-based pricing and places the company under a three-year FTC monitor. Provisions include collaborating with local pharmacies, disclosing drug costs to employers annually, and moving its Switzerland-based rebate aggregator, Ascent Health Services, to the U.S. The FTC estimates the reforms could save patients up to $7 billion over the decade. The settlement also ties direct-to-consumer purchases via TrumpRX to employer standard plans' copays and deductibles. The case was originally brought by the prior administration and reflects ongoing FTC enforcement of PBM practices.