Representatives from insulinmanufacturers blamed a system that requires them to pay higher andhigher rebates to pharmacy-benefit managers to gain access to thepatients whose prescriptions the PBMs manage.

Decisions by two of the world's biggest insulin producers to offer bigger discounts ondrugs used by millions of diabetics are raising questions fromCongress about whether the companies could have done so sooner.

On Wednesday, French drugmaker Sanofi said it would increasediscounts on insulin for some patients. The move follows recentefforts 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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