Philadelphia District Attorney Larry Krasner. Photo: P.J. D'Annunzio/ALM

Add Philadelphia to the growing list of municipal and state governments that are suing drugmakers and pharmacy benefit managers over the cost of insulin.

Larry Krasner, the city's embattled district attorney, filed a lawsuit against nearly 20 pharmaceutical companies and PBMs, on behalf of the Commonwealth of Pennsylvania. "As the district attorney of Philadelphia, I took an oath to seek justice," he said. "Justice requires attacking corporations that put profits ahead of the lives and well-being of the people."

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Among the nearly 20 pharmaceutical companies and pharmacy benefit managers named in the lawsuit, Eli Lilly, Novo Nordisk and Sanofi-Aventis produce roughly 90% of the global insulin supply. CVS Caremark, Express Scripts and OptumRx control approximately 80% of the PBM market. The named defendants are accused of violating the Pennsylvania Unfair Trade Practices and Consumer Protection Law.

More than 1.1 million Pennsylvanians have diabetes. It currently costs as little as $2 per vial to produce insulin, yet the price for patients now ranges from $300 to $700, compared to the $20-per-vial price of the 1990s, according to the district attorney's office.

At a news conference announcing the lawsuit (even though it was filed in October), Krasner, a diabetic himself, was joined by fellow diabetes patients who shared their experiences of having struggled to afford insulin, as well as health-care professionals and advocates.

"This suit is ultimately an easy choice, simply the right thing to do to protect working Philadelphians who can't keep up with this constant, unjustified inflation of health-care costs," City Council member Nicolas O'Rourke said. "Diabetics — around 14% of adults in Philly — are dealing with a plain old scam, run by corporations playing around with people's money over a drug they need to live and thrive. That must end, and I fully support the district attorney's office's working to address this malpractice."

Earlier this month, the city of Baltimore sued Eli Lilly, Novo Nordisk and CVS Caremark, alleging that the companies harmed the city and its citizens by conspiring to inflate the price of insulin. The plaintiffs alleged that the increased prices make insurance more expensive and put a strain on emergency services and medical facilities because people were rationing their medications. Lilly earlier settled a lawsuit brought by the state of Minnesota, agreeing to provide its insulin products at $35 per month to residents with or without insurance for the next five years.

Related: Baltimore sues Eli Lilly, Novo Nordisk over insulin price 'gouging'

Krasner, who has been under fire from Republicans, was impeached in the closing days of the 2021-22 legislative session. The articles of impeachment accused him of misbehavior in office and obstructing a legislative investigation. Opponents allege that his use of prosecutorial discretion, personnel decisions and policies against mass incarceration have contributed to a rise in crime in Philadelphia.

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Alan Goforth

Alan Goforth is a freelance writer in suburban Kansas City. In addition to freelancing for several publications, he has written a dozen books about sports and other topics.