Texas is the latest state to join the legal fight with drug manufacturers and pharmacy benefit managers over the cost of insulin, which has increased 1,000% over the last decade, said AG Ken Paxton.

Novo Nordisk has a price fix solution for uninsured patients with diabetes, but not for HSA holders or people with normal blood sugar.

The PBMs say out-of-pocket insulin costs have fallen sharply since 2019.

"Millions of Americans with diabetes need insulin to survive, yet for many of these vulnerable patients, their insulin drug costs have skyrocketed over the past decade thanks in part to powerful PBMs and their greed," said Rahul Rao, deputy director of the FTC's Bureau of Competition.