ST. GEORGE, Utah, Nov. 16, 2023 (Gephardt Daily) — The Utah Attorney General’s Office has filed a lawsuit against insulin manufacturers and pharmacies over an alleged pricing scheme that has harmed Utah diabetics and their families.
The AG’s office and the Utah Department of Commerce’s Division of Consumer Protection filed a lawsuit Thursday against insulin manufacturers Eli Lilly, Novo, Nordisk and Sanofi, as well as pharmacy benefits managers CVS Caremark, Express Scripts and OptumRx.
“Access to affordable insulin is, literally, a life-or-death issue,” Utah Attorney General Sean Reyes said in a news release. “But insulin makers and PBMs value billions in profits over the lives and well-being of Utahns. The markups and margins on insulin are unconscionable.
“Unrestrained greed cannot be allowed to direct our health care outcomes. This is one of the most egregious cases of avarice and inhumanity I have ever seen. It not only violates the law, but is morally repugnant too.”
While the cost of producing diabetes drugs has decreased over time, manufacturers and PBMs worked together to inflate the reported price of these medications up to 1,000 percent over the last decade, the lawsuit alleges.
PBMs used their significant leverage in the pharmaceutical pricing chain to raise profits instead of lowering prices for consumers, the lawsuit says. Manufacturers are accused of raising the reported prices of diabetes medication only to deceptively refund a significant portion back to PBMs through rebates, discounts, credits and administration fees.
This alleged scheme created an environment where patients were forced to pay artificially high prices for life-saving medications while PBMs and manufacturers reaped record profits, according to the lawsuit.
The AG’s office says patients with diabetes have been collectively overcharged millions of dollars a year for already expensive medication because the manufacturers and PBMs knew they could extract money from patients who would die without it.
“This pricing scheme is not only appalling, it’s also unlawful,” said Margaret Woolley Busse, executive director of the Utah Department of Commerce. “We’ll do everything in our power to hold these companies accountable for their unconscionable actions and for the damage they have caused to Utahns who rely on insulin for survival.”
Roughly 200,000 Utahns or 8% of the adult population suffer from diabetes, while an additional 700,000 have pre-diabetes, according to the news release.
The complaint alleges the total estimated cost after diabetes diagnosis to be $1.7 billion per year just in Utah, as $1 in every $4 in health care is spent caring for diabetes patients.
This excessive price of insulin and the prevalence of the disease have historically led to dangerous patient practices, according to the news release. Some Utah patients have reported rationing or underdosing insulin, injecting expired insulin and even reusing needles to cut costs.
Anyone affected by insulin costs is invited to share their experience at dcp.utah.gov/insulin for potential use in the legal action.
A copy the lawsuit is available here.
