Representatives from insulin manufacturers blamed a system that requires them to pay higher and higher rebates to pharmacy-benefit managers to gain access to the patients whose prescriptions the PBMs manage.

Decisions by two of the world’s biggest insulin producers to offer bigger discounts on drugs used by millions of diabetics are raising questions from Congress about whether the companies could have done so sooner.

On Wednesday, French drugmaker Sanofi said it would increase discounts on insulin for some patients. The move follows recent efforts by Cigna Corp., which runs a major drug plan, and Eli Lilly & Co., another major insulin producer, to lower patients’ out-of-pocket costs for the drugs.

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