Pennsylvania Attorney General Dave Sunday has filed an antitrust lawsuit accusing major insulin manufacturers and pharmacy benefit managers of using a pricing and rebate system that drove up the cost of insulin for patients and state-funded health programs.
The complaint names manufacturers Eli Lilly, Novo Nordisk and Sanofi, along with pharmacy benefit managers CVS Caremark, Express Scripts and Optum Rx. It also names several related companies. The case was filed in the Philadelphia County Court of Common Pleas.
The Attorney General’s Office alleges that list prices for some insulin products increased by more than 1,000 percent even as production costs declined. The state says pharmacy benefit managers favored drugs with higher list prices because those products generated larger rebates, while manufacturers raised prices to compete for placement on insurance formularies.
Sunday’s office says about 1.3 million Pennsylvanians have diabetes and approximately 3.5 million residents are prediabetic. The lawsuit alleges that the pricing system affected patients who paid deductibles or coinsurance tied to list prices, especially people without adequate insurance coverage.
The state also says Pennsylvania spent more than $16.4 billion on prescriptions from the three manufacturers between 2010 and 2025 through Medicaid, the Children’s Health Insurance Program and state employee health plans.
Pennsylvania is seeking court orders to stop the alleged conduct, restitution, civil penalties and other relief. The filing presents the state’s allegations; the defendants have not been found liable, and the claims will be decided through the court process.
