CVS Caremark reached a settlement with the Federal Trade Commission over an insulin-related dispute involving pharmacy benefit manager (PBM) formulary practices. The agreed terms, disclosed Tuesday, resemble requirements imposed in an earlier FTC deal with Express Scripts. Under the arrangement, the PBM is required to stop preferring higher-cost drug versions on standard formularies. The FTC’s action puts further pressure on PBMs’ drug selection strategies and could influence manufacturer access expectations and reimbursement economics. For biotech and pharma, the settlement reinforces ongoing scrutiny into how formulary placement affects net pricing and patient access—especially in high-cost therapeutic areas where insulin remains a key test case.