Insulin Pricing Lawsuit Filed by Massachusetts Attorney General

Joy Campbell, Massachusetts attorney general, has filed a lawsuit against a slew of defendants, including insulin manufacturers Eli Lilly, Sanofi, Novo Nordisk, as well as pharmacy benefit managers (PBMs) Optum Rx, Express Scripts, and CVS Caremark, for their role in unfair and deceptive insulin pricing.

The Lawsuit

The complaint alleges that the PBM defendants worked with the pharmaceutical manufacturer defendants to artificially increase the market price of insulin for their benefit and to the harm of individuals with diabetes in Massachusetts.

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

The attorney general’s complaint alleges that the drug manufacturers artificially raised prices of insulin and paid kickbacks to the PBMs in a quid pro quo arrangement for inclusion in PBM formularies. The PBMs allegedly granted preferred formulary status to the drugs with the highest list price while excluding less expensive medications.

AG Campbell further alleges that the defendants violated the Massachusetts Consumer Protection Act and financially enriched themselves at the expense of the public. The attorney general is asking the court to order the defendants to pay restitution to impacted Massachusetts patients and to permanently stop engaging in unfair pricing schemes.

According to the complaint, the manufacturer defendants have raised the price of insulin in Massachusetts by up to 1000% in the past decade.

Massachusetts Senator Cindy Friedman commented on the lawsuit in a press release: “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.”

The lawsuit was filed in Suffolk Superior Court in mid-January 2025. Similar lawsuits are likely to be filed by other states.

References:

The Commonwealth of Massachusetts vs Eli Lilly and Company; Novo Nordisk Inc.; Sanofi-Aventis US LLC; Evernorth Health, Inc. (formerly Express Scripts Holding Company); Express Scripts, Inc.; Express Scripts Administrators, LLC; ESI Mail Pharmacy Service, Inc.; Express Scripts Pharmacy, Inc.; Ascent Health Services LLC; Medco Health Solutions, Inc.; CVS Health Corporation; CVS Pharmacy, Inc.; Caremark Rx, LLC; CaremarkPCS Health, LLC; Caremark, LLC; Zinc Health Ventures, LLC; Zinc Health Services, LLC; UnitedHealth Group, Inc.; OptumRx, Inc.; Emisar Pharma Services LLC; and OptumInsight, Inc. Superior Court Civil Action No 2584CVOO86. Commonwealth of Massachusetts; 2025. https://www.mass.gov/doc/insulin-pricing-complaint/download

AG Campbell files lawsuit against major insulin manufacturers and pharmacy benefit managers for unfair and deceptive insulin pricing. Press release. Mass.gov. Published January 14, 2025. Accessed February 10, 2025. https://www.mass.gov/news/ag-campbell-files-lawsuit-against-major-insulin-manufacturers-and-pharmacy-benefit-managers-for-unfair-and-deceptive-insulin-pricing