The Federal Trade Commission (FTC) has reached a significant settlement with Express Scripts, addressing claims of inflated insulin prices. This deal represents a major shift in the pharmacy benefit management (PBM) landscape, as the FTC aims to enhance transparency and reform rebate practices to lower drug costs for American patients. The settlement not only targets insulin pricing but also signals broader implications for drug pricing and oversight in the industry. Express Scripts has committed to fundamental changes in its operations, which may reshape how drug pricing is conducted going forward. Cigna, the parent company of Express Scripts, has also announced its intention to overhaul drug pricing practices in response to the settlement.