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Press Release  AG Campbell Files Lawsuit Against Major Insulin Manufacturers And Pharmacy Benefit Managers For Unfair And Deceptive Insulin Pricing

Complaint Alleges Insulin Manufacturers Unfairly Raised Price of Insulin, Paid Portion of Profits Back to Pharmacy Benefit Managers for Offering Their Drugs
For immediate release:
1/14/2025
  • Office of the Attorney General

Media Contact   for AG Campbell Files Lawsuit Against Major Insulin Manufacturers And Pharmacy Benefit Managers For Unfair And Deceptive Insulin Pricing

Sydney Heiberger, Press Secretary

BOSTON — Massachusetts Attorney General Andrea Joy Campbell has filed a lawsuit in Suffolk Superior Court against major insulin manufacturers Eli Lilly, Sanofi, Novo Nordisk and pharmacy benefit managers (“PBMs”) Optum RX, Express Scripts, and CVS Caremark for their unfair and deceptive insulin pricing scheme. 

In her complaint, AG Campbell alleges that the PBM defendants worked in coordination with the manufacturer defendants to distort the market for diabetic treatments to their benefit at the expense of Massachusetts diabetics. In the last decade alone, the manufacturer defendants have increased the prices of their insulins up to 1,000%.

“Insulin manufacturers and pharmacy benefit managers worked together to drive up prices and take advantage of vulnerable diabetes patients,” said AG Campbell. “Our lawsuit seeks to hold these companies accountable for their greed while protecting our consumers from exorbitant health care costs.”

"While the Legislature recently capped out-of-pocket insulin costs and brought much-needed oversight and data collection requirements to pharmaceutical manufacturing companies and pharmacy benefit managers, so much is still unknown about drug pricing practices, and I am extremely grateful to Attorney General Campbell for taking this action,” said Senator Cindy Friedman. “As a state we must continue our efforts to end the practice of pricing life-saving essential medications to increase profits at the expense of so many residents who can no longer afford them."

"I applaud Attorney General Andrea Campbell for bringing this lawsuit forward. The legislature is focused on the opaque business practices PBMs have created, which can lead to increased drug prices and limited transparency for consumers, employers and pharmacies. I look forward to working with the AGO on this important issue," said Representative John Lawn.

According to the AG’s complaint, synthetic insulin drugs, which today cost the manufacturers less than $2 to produce and were originally priced at $20 when released in the late 1990s, are now priced between $300 and $700. 

In Massachusetts, the American Diabetes Association estimates around 500,000 people live with diabetes. An additional 1.8 million Massachusetts residents have prediabetes. According to the CDC, many diabetics ration or under-dose their diabetes medications, inject expired insulin, reuse needles, and starve themselves to control their blood sugars due to the high price of insulin.

The AG’s complaint alleges that the manufacturers artificially and willingly raised the prices of insulin and then paid a significant, undisclosed portion back to the PBMs as a quid pro quo for inclusion in the PBMs’ standard offerings. The PBM defendants, which control 80% of the pharmacy benefit market, design and implement approved drug lists (known as formularies) which determine which drugs are available, at what out-of-pocket costs, and with what restrictions for insured consumers. AG Campbell alleges that the PBMs granted preferred formulary status to the drug with the highest list price while excluding lower priced drugs.

The complaint also claims that the PBMs represented that they used their market power to drive down prices for diabetes medications and increase access to affordable drugs, when in reality, the PBMs and manufacturers named in the AG’s lawsuit have been working together to drive up drug prices for Massachusetts diabetics and foreclose access to lower priced diabetic treatments in order to increase their profits.

The AGO alleges the companies’ actions violate the Massachusetts Consumer Protection Act and constitute unjust enrichment and an unlawful civil conspiracy. The office is requesting the Court order the defendants to pay restitution to impacted Massachusetts consumers and penalties to the Commonwealth. Additionally, the AGO is asking the Court to order the defendants to permanently cease engaging in unfair and deceptive practices.

This case is being handled by Assistant Attorney General Michael Wong, with assistance from Division Chief Sandra Wolitzky and Deputy Division Chief Ethan Marks, all of the AGO’s Health Care Division.

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Media Contact   for AG Campbell Files Lawsuit Against Major Insulin Manufacturers And Pharmacy Benefit Managers For Unfair And Deceptive Insulin Pricing

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