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The Federal Trade Commission (FTC) and the U.S. Department of Health and Human Services (HHS) have jointly issued a Request for Information (RFI) to investigate the impact of group purchasing organizations (GPOs) and drug wholesalers on access to generic pharmaceuticals. The RFI aims to understand how these entities contribute to generic drug shortages and whether they are complying with legal obligations under the Clayton Act and the Robinson-Patman Act. The FTC and HHS are seeking public input on market concentration, contracting practices, and potential causes of drug shortages. The public has 60 days to submit comments, which will be posted on Regulations.gov.

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Joint request seeks information on impact of group purchasing organizations and drug wholesalers on access to generic pharmaceuticals

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Today the Federal Trade Commission (FTC) and the U.S. Department of Health and Human Services (HHS) jointly issued a Request for Information to understand how the practices of two types of pharmaceutical drug middlemen groups—group purchasing organizations (GPOs) and drug wholesalers—may be contributing to generic drug shortages. 

In the Request for Information (RFI), the FTC and HHS are seeking public comment regarding market concentration among large health care GPOs and drug wholesalers, as well as information detailing their contracting practices. The joint RFI seeks to understand how both GPOs and drug wholesalers impact the overall generic pharmaceutical market, including how both entities may influence the pricing and availability of pharmaceutical drugs. The joint RFI is asking these questions to help uncover the root causes and potential solutions to drug shortages. 

“For years Americans have faced acute shortages of critical drugs, from chemotherapy to antibiotics, endangering patients,” said FTC Chair Lina M. Khan. “Our inquiry requests information on the factors driving these shortages and scrutinizes the practices of opaque drug middlemen. We look forward to public input as we assess how enforcers and policymakers can best address chronic drug shortages and promote a resilient drug supply chain.”

“When you’re prescribed an important medication by your doctor and you learn the drug is out of stock, your heart sinks,” said Secretary Xavier Becerra. “This devastating reality is the case for too many Americans who need generic drugs for ADHD, cancer, and other conditions. Today’s announcement is part of the Biden-Harris Administration’s work to tackle health care monopolies and lessen the impact on vulnerable patients who bear the brunt of this lack of competition. Today’s initiative is just one more action by HHS to best address shortages of generic drugs.” 

GPOs serve as intermediaries in the pharmaceutical industry by negotiating deals for generic drugs and other medical supplies between health care providers—including hospitals, physicians, nursing homes, and home health agencies—and manufacturers, distributors, and others who sell to health care providers. Drug wholesalers are another type of intermediary group which purchase drugs directly from manufacturers and deliver them to health care providers. 

The joint RFI is the latest effort by the FTC and HHS to promote competition in pharmaceutical markets to ensure that every consumer has access to high-quality, affordable care. As announced in December 2023, the FTC, HHS and the Department of Justice are partnering on new initiatives which will include a forthcoming joint RFI to seek input on how private-equity and other corporations’ control of health care is impacting Americans.

The joint FTC and HHS RFI released today is requesting public input via comments, documents, and data regarding several topics with respect to generic drug markets and the potential causes of generic drug shortages, including:

  • Whether and to what extent manufacturers, GPOs, and drug wholesalers are complying with their legal obligations under Section 3 of the Clayton Act and the Robinson-Patman Act.

  • Whether and to what extent do the available protections for GPOs under the Federal Anti-Kickback Statute affect market concentration and contracting practices by GPOs, as well as drug shortages.
  • Whether and to what extent market concentration among GPOs and drug wholesalers has impacted smaller health care providers and rural hospitals.

  • Whether and to what extent concentration among GPOs and drug wholesalers has disincentivized suppliers from competing in generic drug markets.

  • The impact of the prevailing GPO compensation model, which may rely on rebates, chargebacks, and administrative fees from manufacturers and suppliers in exchange for favorable treatment, on generic manufacturers and other suppliers.

The public will have 60 days to submit comments at Regulations.gov. Once submitted, comments will be posted to Regulations.gov.

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The Federal Trade Commission develops policy initiatives on issues that affect competition, consumers, and the U.S. economy. Follow the FTC on social media, read consumer alerts and the business blog, and sign up to get the latest FTC news and alerts.

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Office of Public Affairs

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415-848-5121

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Summary: Enforcement and Policy u2013 Federal Trade Commission (FTC)

The Federal Trade Commission (FTC) is a government agency that enforces federal competition and consumer protection laws to prevent anticompetitive, deceptive, and unfair business practices. The FTC’s mission is to protect consumers and competition by preventing anticompetitive, deceptive, and unfair business practices through law enforcement, advocacy, and education without unduly burdening legitimate business activity.

Enforcement:

The FTC enforces federal competition and consumer protection laws, including:

Antitrust laws to prevent anticompetitive conduct and promote competitive markets
Deceptive and unfair business practices laws to protect consumers
Consumer protection laws to protect consumers from fraud and other unfair practices

Policy:

The FTC develops policy initiatives on issues that affect competition, consumers, and the U.S. economy. The FTC’s policy goals include:

Promoting competition and protecting consumers through enforcement of antitrust and consumer protection laws
Developing policy initiatives to address issues affecting competition, consumers, and the U.S. economy
Providing guidance and resources for businesses to comply with federal laws and regulations

Recent Initiatives:

The FTC has issued a joint Request for Information (RFI) with the U.S. Department of Health and Human Services (HHS) to understand the impact of group purchasing organizations (GPOs) and drug wholesalers on access to generic pharmaceuticals.
The joint RFI seeks public comment on market concentration among large health care GPOs and drug wholesalers, as well as information detailing their contracting practices.
The FTC and HHS are seeking information on the factors driving generic drug shortages and the practices of opaque drug middlemen, with the goal of addressing chronic drug shortages and promoting a resilient drug supply chain.

Public Opportunity:

The public has 60 days to submit comments at Regulations.gov on the joint RFI. Comments will be posted to Regulations.gov once submitted.

Additional Resources:

The FTC provides legal resources and guidance to understand business responsibilities and comply with the law.
The FTC offers consumer advice and guidance on topics such as shopping and donating, credit and loans, and identity theft.
The FTC provides business guidance and resources on topics such as advertising and marketing, credit and finance, and privacy and security.

Contact:

The FTC’s Office of Public Affairs can be reached at 415-848-5121 for more information.

Federal Trade Commission

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