Sept 20 (Reuters) - The U.S. Federal Trade Commission

sued the country's three largest pharmacy benefit managers on

Friday, accusing them of steering diabetic patients towards

higher priced insulin in order to reap millions of dollars in

rebates from pharmaceutical companies.

The case accuses UnitedHealth Group Inc's ( UNH ) Optum

unit, CVS Health Corp's ( CVS ) CVS Caremark and Cigna Corp's

Express Scripts of unfairly excluding lower cost insulin

products from lists of drugs covered by insurers.

Driving down drug prices has been a key goal for the Joe

Biden administration, and Vice President Kamala Harris, the

Democratic nominee, has emphasized her work for patients, and in

particular on lowering insulin prices, on the campaign trial.

The conduct hurt patients, such as those with coinsurance

and deductibles, who were not eligible for the rebated price.

The three PBMs together administer 80% of all prescriptions in

the U.S., according to the case, which was filed in the FTC's

in-house court.

The suit also named Zinc Health Services, Ascent Health

Services, and Emisar Pharma Services, purchasing organizations

created by the companies in recent years.

Rahul Rao, Deputy Director of the FTC's Bureau of

Competition, said in a statement that the three pharmacy benefit

managers are "medication gatekeepers" that have "extracted

millions of dollars off the backs of patients who need

life-saving medications."

"Millions of Americans with diabetes need insulin to

survive, yet for many of these vulnerable patients, their

insulin drug costs have skyrocketed over the past decade thanks

in part to powerful PBMs and their greed," he said.

The FTC did not sue the three major makers of insulin, Eli

Lilly ( LLY ), Sanofi, and Novo Nordisk,

but it did criticise their role in what it called a broken

system, and said it reserves the right to sue the pharmaceutical

companies later.

The three PBMs have criticised the FTC's approach to the

industry, accusing it of bias. Express Scripts sued the FTC

earlier this week seeking to force it to withdraw a report that

said PBMs enrich themselves at the expense of smaller

pharmacies.