Insulin Pricing Lawsuit – Healthcare Plan Reimbursement

The Insulin Pricing lawsuits claim that insulin manufacturers and pharmacy benefit managers (PBMs) have artificially inflated the price of insulin at the expense of self-funded health plans and their members and beneficiaries.

Our law firm is working with a consortium of nationally recognized law firms to investigate cases of insulin overpricing on behalf of self-funded healthcare plans and their holders, including government entities (cities, counties, and states) and unions.

We have taken on and defeated such corporate giants as Big Tobacco, BP, DuPont, Bayer, Johnson & Johnson, as well as the entire spectrum of opioid producers, distributors, and retail drugstore chains. In a nutshell, we litigate complicated cases, and we are driven to take on this fight.

Litigation Updates in the Insulin Pricing Lawsuit – Healthcare Plan Reimbursement

Our Insulin Pricing attorneys aim to keep our clients informed of the progress and status of these lawsuits. Please come back to this page for regular, monthly updates.

I

November 2024 Insulin Pricing Lawsuit Updates

CVS, Cigna, and UnitedHealth are suing the Federal Trade Commission (FTC) to block its lawsuit accusing their pharmacy benefit managers of inflating insulin prices. The companies argue that the FTC’s case, filed in its administrative court rather than federal court, violates their Fifth Amendment right to due process. The FTC criticized the lawsuit as a diversion from the PBMs’ alleged misconduct. (HealthcareDive.com)

September 2024 Insulin Pricing Lawsuit Updates

The federal government has filed a lawsuit against major pharmacy benefit managers (PBMs) — Caremark, Express Scripts, and OptumRx — accusing them of anticompetitive practices that have contributed to the rising cost of insulin. These three companies, which process about 80% of U.S. prescriptions, are alleged to have used a rebate system that drives up drug prices, making insulin increasingly unaffordable for diabetic patients, according to the Federal Trade Commission (FTC). (Associated Press)

August 2024 Insulin Pricing Lawsuit Updates

A federal appeals court has ruled that California’s lawsuit against pharmacy benefit managers CaremarkPCS Health LLC and Express Scripts Inc. for allegedly inflating insulin prices will remain in U.S. court. The Ninth Circuit Court of Appeals supported the PBMs’ claim that their rebate negotiations with drug manufacturers, involving two federal government programs, give the federal court jurisdiction over the case. Although California attempted to exclude any challenges related to these federal programs to keep the case in state court, the court found the disclaimer insufficient.

July 2024 Insulin Pricing Lawsuit Updates

The Federal Trade Commission (FTC) plans to sue three major U.S. health companies—Optum Rx (UnitedHealth Group), Caremark (CVS Health), and Express Scripts (Cigna)—over their roles as pharmacy benefit managers (PBMs). The FTC alleges that these companies, which negotiate drug prices, are inflating costs for patients, particularly for medications like insulin. This action follows a report by the Wall Street Journal confirming the FTC’s intentions to target these PBMs, which are all tied to health insurers. (CNBC]

June 2024 Insulin Pricing Lawsuit Updates

As of June 3, 2024, 60 cases are pending in the Insulin Pricing Litigation MDL No. 3080.

May 2024 Insulin Pricing Lawsuit Updates

Judge Martinotti entered Case Management Order #9, enabling plaintiffs whose action qualifies for transfer to the MDL to file their action directly in the U.S. District Court for the District of New Jersey. Direct filing will eliminate potential delays that can happen with the transfer of actions and will make the judicial process in this MDL more efficient.

April 2024 Insulin Pricing Lawsuit Updates

The Insulin Pricing MDL judge entered Case Management Order #8, establishing guidelines for the creation and maintenance of a litigation fund for shared expenses incurred for the common benefit of MDL 3080’s Self-Funded Payer Track.

Judge Martinotti also entered Case Management Order #5 setting the next case management conference for the Insulin Pricing MDL for April 9, 2024.

February 2024 Insulin Pricing Lawsuit Updates

In a settlement filed on February 7, 2024, in the U.S. District Court for the district of New Jersey, Eli Lilly & Co. agreed to cap the price of insulin at $35 per month for Minnesota residents with prescriptions, following a lawsuit over insulin pricing since 2018. The settlement, pending approval, would last five years and includes provisions for accessibility and donations to clinics. (Bloomberg Law)

January 2024 Insulin Pricing Lawsuit Updates

District of Utah case number 2:24-cv-27 has been transferred to the District of New Jersey and assigned civil action number: 24-cv-536 In Re: Insulin Pricing Litigation, MDL 3080 (Justia).

December 2023 Insulin Pricing Lawsuit Updates

On December 7, 2023, it was announced that Levin Papantonio Attorney Brandon Bogle was appointed as Co-Lead Counsel for the Self-Funded Payer Track in the Insulin Pricing multidistrict litigation (MDL No. 3080).

The State Attorney General Track will encompass legal actions initiated on behalf of states, while the Self-Funded Payer Track will involve individual actions on behalf of self-funded payers or groups of self-funded payers. This category includes entities such as local governments (counties, cities, schools, and non-profit organizations, among others) that cover the costs of prescription drugs for health plan members with prescription drug coverage.

November 2023 Insulin Pricing Lawsuit Updates

All parties involved in the MDL submitted suggestions for the selection of Lead Counsel, Executive and Steering Committees, and Liaison Counsel on November 27, 2023.

September 2023 Insulin Pricing Lawsuit Updates

Schenectady County joined the lawsuit against insulin manufacturers for artificial inflation of prices for their diabetes medications. The County legislature voted on the decision to take legal action, stating its commitment to “seeking justice and reclaiming taxpayer funds” by participating in the lawsuit.

August 2023 Insulin Pricing Lawsuit Updates

The JPML announced its decision to centralize 13 pending insulin pricing scheme cases in a multidistrict litigation (MDL 3080). These cases, as well as future tag-along cases filed by both government and private entities, will be transferred to the District of New Jersey. The Honorable Brian R. Martinotti was assigned the cases. The judge was already presiding over three actions related to this matter.

July 2023 Insulin Pricing Lawsuit Updates

The City of Cleveland filed a Complaint against insulin drug manufacturers and pharmacy benefit managers (PBMs), alleging that they artificially inflated insulin prices at the expense of self-funded health plans, their members, and beneficiaries.

According to a survey conducted by U.S. Senator Elizabeth Warren‘s office and released this month, Americans without health insurance are paying an average of $98 for Eli Lilly’s generic insulin, despite the company’s May 1 pledge to reduce its list price to $25 per vial. The survey, which included more than 300 U.S. pharmacies and took place from June 9 to 28, revealed that a third of the pharmacies charged uninsured patients $164 or more for Lilly’s Insulin Lispro, with the highest price reaching $330.

May 2023 Insulin Pricing Lawsuit Updates

LPR filed a lawsuit on behalf of Lake County, Illinois. According to the Complaint, drug manufacturers and pharmacy benefit managers (PBMS) orchestrated an insulin pricing scheme that benefited defendants—boosting the prices of life-saving insulin during a diabetes epidemic. The case was filed in the U.S. District Court Northern District of Illinois Eastern Division.

What Are the Insulin Pricing Lawsuits?

Despite the drug being over a century old, declining manufacturing costs, and few advancements since its original formulation, insulin prices have soared over the past 20 years. Its list price has climbed by more than 1000% since 2003, far above the rate of inflation for consumer goods and services.

The expense of treating diabetes in the United States is extremely high, despite the widespread availability of effective treatments, including insulin. According to a 2022 Yale study, 14% of American insulin users or 1.2 million people spend “catastrophic” amounts on the drug, which means they spend at least 40% of their post-subsistence income on it.

Who Can File an Insulin Overpricing Lawsuit?

The dramatic, unjustifiable increases in the price of insulin, a life-saving diabetes medication, have caused self-funded healthcare plans and their healthcare plan holders to sustain substantial damages. Our legal team is investigating cases on behalf of these potential plaintiffs.

Our law firm is working with a consortium of nationally recognized law firms to hold accountable the various entities dominating the insulin market and controlling its pricing.

Pharmacy Benefit Managers

According to the National Center for Policy Analysis (PBM Resources), three pharmacy benefit managers (PBMs) control 89% of the PBM market:

  • Express Scripts
  • CBS Caremark
  • OPTUMRx

Insulin Manufacturers

According to a 2019 study, Health Economics, A Perspective on Global Access to Insulin, three pharmaceutical companies control 99% of the insulin market by value and 96% by volume:

  • Novo Nordisk
  • Eli Lilly
  • Sanofi

Why Choose Our Law Firm to Handle Your Insulin Pricing Lawsuit?

Since 1955, our law firm has successfully handled lawsuits against the largest corporations in the world. We were one of the firms that led the national litigation on behalf of numerous government agencies against the tobacco industry and the opioids industry.

Experience Fighting the Opioid Industry

Our law firm represented more than 1,000 government agencies against the wholesale distributors, retailers, and manufacturers of opioids in order to recover the immense damages sustained as a result of these companies creating the opioid epidemic.

We were one of a very few firms appointed to the settlement committee that negotiated more than $50 billion in settlements with the various defendants. This included Walgreens’ $500-million settlement agreement with the State of New Mexico for the company’s reckless dispensing of opioids that facilitated the State’s opioid crisis.

Experience With Multi-Defendant Cases

We have successfully resolved numerous complex cases involving multiple defendants and are aware of when to do so. We’re dedicated to making sure you get compensated for any excess money you paid for insulin goods as well as bringing down future insulin prices.

A Consortium of Nationally Recognized Law Firms

Our law firm is part of an insulin overpricing legal consortium unlike any other. The combined strength from this alliance of leading law firms offers us the ability to successfully take on these industry titans in court. We’re ready to hold these monolithic businesses responsible, as we frequently have in the past. Each of the firms in our consortium is well-known on a national level and has a history of taking on challenging cases all the way to trial and beyond.

Our lawyers are listed in Best Lawyers in America and The National Trial Lawyers Hall of Fame. We founded and continue to host Mass Torts Made Perfect, the largest mass torts conference in the world where we teach thousands of attorneys how to successfully handle complex cases such as the insulin overpricing lawsuits.

Why Have Insulin Prices Skyrocketed?

Contrary to the sharp rise in insulin prices, production costs have decreased thanks to efficient and improved procedures. According to a study published in September 2018, a reasonable price for a person’s year supply of human insulin should be between $48 and $71 while still providing manufacturers with sizable profits. According to a different study, insulin makers might turn a profit by pricing less than $2 for each vial. Still, in 2016, the typical diabetic spent $5,705 for insulin.

A Fraction of Insulin Profits Spent on Research & Development

Since the 1990s, insulin has seen few advancements. Only a small portion of the manufacturers’ excessive earnings have been allocated to R&D, and the investments they have made have mostly gone toward delivery systems rather than altering the drug s composition.

Eli Lilly, for instance, invested $395 million in R&D between 2014 and 2018. The company spent $1.5 billion on insulin sales and marketing over that time period, while its insulin line brought in $22.4 billion in revenue. Similarly, Sanofi spent a mere $902 million on insulin R&D yet generated net sales of approximately $37 billion for their insulin drugs.

Only one logical answer greed–remains for the otherwise puzzling question of why insulin prices have risen so much.

What Are the Main Legal Issues Involving Insulin Overpricing?

Legal claims are based on the misbehavior of the PBMs and insulin manufacturers. We are filing claims on behalf of clients for violations of RICO, deceptive and unfair trade practices, and for unjust enrichment, among other potential claims.

Through these claims, we demand monetary damages and disgorgement for the excessive insulin prices that self-funded healthcare plans and their members have previously paid, and we work to ensure that those rates are not charged in the future.

What Compensation is Recoverable in an Insulin Overpricing Lawsuit?

Significant monetary relief and equitable compensation is being sought in the insulin overpricing lawsuits.

Potential remedies include:

  • Money paid to cover falsely inflated insulin pricing. To both reimburse claimants for the costs they have unjustifiably suffered and to deter similar future behavior from these defendants and others like them, the damages granted in some cases may be trebled.
  • Injunctive relief to halt the insulin pricing scheme. This would protect self-funded plans and their members against future financial harm.
  • Disgorgement of illicit revenues by PBMs and manufacturers
  • Punitive damages intended to punish prior misconduct and discourage misconduct in the future

The Diabetes Epidemic: at the Mercy of High Insulin Pricing

Every day, more than 7 million people need insulin. Because diabetes is so common and severe, insulin is a crucial, life-saving drug.

Approximately 88 million Americans have prediabetes, and over 34.2 million Americans (or 10.5% of the population) have diabetes. Despite the fact that there are viable treatments for the condition, diabetes is the seventh largest cause of mortality in the nation. About 275,000 Americans per year die from diabetes as the primary cause of death.

Since its discovery in 1921, insulin has been obtained from animals. Humulin, the first biosynthetic human insulin, was developed in 1978. The FDA assessed and authorized Humulin on October 28, 1982. Since the 1980s, there haven’t been many scientific developments related to insulin.

How Does the Rising Price of Insulin Affect People With Diabetes?

According to a 2018 study published by the American Diabetes Association, the cost of insulin resulted in several types of behavior changes amongst insulin users in 2017, as indicated below:

  • 26%: Regularly take less than the prescribed dose
  • 23%: Missed 1-2 doses per week
  • 23%: Doctor selected a less expensive insulin
  • 20%: Missed 1-2 doses per month
  • 20%: Used a patient assistance program
  • 20%: Used a discount drug program or website
  • 18%: Did not fill at least one insulin prescription
  • 17%: Used a coupon or rebate
  • 14%: Their health or Rx plan chose a less expensive insulin

The study also reported that these insulin-cost-related behavior changes caused a range of health, lifestyle, and emotional effects, including:

  • Becoming ill or very ill
  • Sluggishness
  • High blood sugar levels
  • Inability to participate in activities
  • Difficulty watching diet
  • Anxiety

Why Choose Our Law Firm to Handle Your Insulin Pricing Lawsuit

Experience Fighting the Opioid Industry

We have taken on and defeated such corporate giants as Big Tobacco, BP, DuPont, Bayer, Johnson & Johnson, as well as the entire spectrum of opioid producers, distributors, and retail drugstore chains. In a nutshell, we litigate complicated cases.

Experience With Multi-Defendant Cases

We have successfully resolved numerous complex cases involving multiple defendants and are aware of when to do so. We’re dedicated to making sure you get compensated for any excess money you paid for insulin goods as well as bringing down future insulin prices.

A Consortium of Nationally Recognized Law Firms

Our law firm is part of an insulin overpricing legal consortium unlike any other. The combined strength from this alliance of leading law firms offers us the ability to successfully take on these industry titans in court. We’re ready to hold these monolithic businesses responsible, as we frequently have in the past. Each of the firms in our consortium is well-known on a national level and has a history of taking on challenging cases all the way to trial and beyond.

News Media Coverage of Increasing Insulin Costs

Oct. 18, 2022: Over a Million Americans Are Rationing Insulin Due to High Cost Drugs.com

A new study reports that more than 1 million American diabetics resort to rationing their insulin because they cannot afford the medication. Underuse of insulin to prompt ketoacidosis, a potentially fatal complication in which blood sugar levels spike to the point of blood becoming highly acidic. Lack of competition and of generic alternatives are cited as some of the reasons the pricing of insulin tripled between 2002 and 2013.

Sep. 12, 2022: Insulin costs increased 600% over the last 20 years. States aim to curb the price National Public Radio (NPR)

Leading manufacturers of insulin have boosted their prices of the diabetes medication by more than 600% over the last two decades. State and federal efforts to curb the trend.

March 31, 2022: Why insulin prices are troublingly high The Hill

The Hill traces the history of insulin, including its discovery and patent; the Department of Justice s investigation of Eli Lilly, Merck and Bristol-Myers Squibb for anti-competitive pricing tactics; ineffective legislative attempts to affect the price of the drug; drug manufacturers opaque pricing system; and other factors leading to today s out-of-control pricing for the life-saving medication.

Scientific Studies Regarding Insulin Overpricing in the U.S.

Comparing Insulin Prices in the U.S. to Other Countries

Office of the Assistant Secretary for Planning and Evaluation, Sep. 23, 2020

This study compares international prices of insulins using a price index approach. According to the results, in the U.S., the average gross manufacturer priced a standard unit of insulin in 2018 at more than 10 times the price in a sample of 32 foreign countries.

Insulin Cost and Pricing Trends

American Action Forum, April 2, 2020

Co-authored by the former director of Human Welfare Policy at the American Action Forum, this research reveals trends in rising costs of diabetes medication. Diabetes costs the U.S. $327 billion in 2017, according to the researchers. Before accounting for rebates or discounts, insulin costs make up 20% of the direct costs of treating this disease.

Insulin Affordability Survey

American Diabetes Association, Vault Consulting, LLC

American Diabetes Association enlisted Vault Consulting to study how perceptions of insulin affordability among U.S. users of the medication affected the users behaviors. According to the study, around 27% of respondents reported that insulin cost had affected their purchase or use of insulin in the past year.

Let Our Leaders in Pharma Litigation Handle Your Lawsuit

Our law firm has been fighting to recover damages on behalf of clients in civil litigation. During this time, we have earned the status of a national leader in pharmaceutical and medical device injury lawsuits.

This reputation stems from a solid track record of results, including more than 150 jury verdicts equaling or exceeding $1 million and a total of more than $80 billion in jury verdicts and settlements.

Our firm’s knowledge and expertise fuel the legal industry with our annual Mass Torts Made Perfect conference. Lawyers thousands of them attend this event to learn from us how to handle lawsuits against large corporations in the world.