A person tests the flow of a Sanofi Lantus brand SoloStar insulin pen in an arranged photograph taken in the Brooklyn borough of New York, U.S., on Friday, April 5, 2019. Makers of top-selling insulin products will continue to bear the brunt of Congress' drug-pricing efforts in 2019 as diabetes remains a source of frustration to policy makers in both parties. Photographer: Alex Flynn/Bloomberg
The city of New Haven, Conn., alleges that Cigna, CVS Health and UnitedHealth Group inflated insulin prices over the past decade in a lawsuit filed in federal district court. The sweeping complaint includes pharmacy benefit managers Express Scripts, Evernorth, CVS Caremark and Optum Rx; insulin manufacturers Eli Lilly, Novo Nordisk and Sanofi; and group purchasing organizations.
New Haven offers self-insured health plans for employees and eligible retirees. Because of what it terms an "insulin pricing scheme," it said it paid artificially inflated prices for insulin and other diabetes drugs from at least 2010 to 2019. Manufacturers allegedly set inflated list prices and directed secret rebates, administrative fees and other undisclosed payments to PBMs. The PBMs, in return, allegedly gave these higher-priced drugs preferred spots on their formularies.
Sanofi and Novo Nordisk raised insulin list prices at the same time at least 13 times between 2009 and 2015, matching each other down to the decimal point within days and sometimes hours, Insurance Business reported. At the same time, Eli Lilly communications cited in the lawsuit show executives tracking competitors' moves and matching 9.9% price increases.
New Haven seeks triple damages, punitive damages and injunctive relief under the Racketeer Influenced and Corrupt Organizations Act, the Sherman Antitrust Act, the Connecticut Antitrust Act and the Connecticut Unfair Trade Practices Act.
A CVS Caremark spokesperson denied the allegations in a statement to Becker's Hospital Review.
"Pharmaceutical companies alone are responsible for the prices they set in the marketplace for the products they manufacture," a spokesperson said. "Nothing in our agreements prevents drug manufacturers from lowering the prices of their insulin products, and we would welcome such an action. Allegations that we play any role in determining the prices charged by manufacturers for their products are false, and we intend to vigorously defend against this baseless suit."
The New Haven lawsuit joins a growing list of litigation against manufacturers and PBMs over insulin pricing:
- Last month, Missouri Attorney General Catherine Hanaway announced that her office has filed suit against 19 PBMs and drug manufacturers operating in the state.
- Delaware sued manufacturers and PBMs for allegedly increasing insulin prices by as much as 1,000% over the past 15 years.
- Oregon filed a lawsuit seeking $900 million in damages from the nation's largest insulin manufacturers and PBMs, alleging that they worked together to artificially inflate the price of insulin and other critical diabetes medications at the expense of the state's patients and families.
- Virginia sued the nation's largest PBMs and insulin manufacturers for alleged violations of the Virginia Consumer Protection Act. The lawsuit alleged a yearslong insulin pricing scheme that artificially inflated the price of diabetes medications and deceived consumers about those inflated prices.
- Indiana filed a similar lawsuit late last year, including against in-state drugmaker Eli Lilly.
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