Bonta’s Attorney General has sued the country’s largest producer of insulin, Pharmacy Benefit Manager for illegal practices, overdoses.

Courts accuse companies of using illegal, unfair, and deceptive practices to induce raising the cost of the life-saving drug.

SACRAMENTO — California Attorney General Rob Bonta today announced a lawsuit against the nation’s largest insulin companies and pharmacy benefit managers (PBMs) for raising the price of the life-saving drug. through illegal, unfair, and deceptive business practices in violation of the California Competition Act. In America, insulin is very expensive and many diabetics struggle to afford it even if it is covered by health plans, forcing them to share their use – sometimes with dire consequences. More than 3 million adults in California – more than 10% of the adult population – have diabetes. The lawsuit accuses the manufacturers Eli Lilly, Novo Nordisk, and Sanofi, and the managers of medical benefits CVS Caremark, Express Scripts, and OptumRx, have used the power of the market to spend on patients. A 2021 report found that insulin costs about ten times more in the United States than abroad.

“Insulin is a necessary drug that millions of Americans rely on for their health, but it is not a luxury. With today’s lawsuit, we are challenging the pharmaceutical companies and PBMs are increasing and deflating the cost of life-saving drugs at the expense of vulnerable patients. said the Attorney General to Bonta. “No one should be forced to share or go without basic medications that can mean the difference between life or death. California will continue to be a leader in the fight to to ensure that everyone has equal access to affordable health care and the prescription drugs they need to stay healthy.”

The three manufacturers cited in the lawsuit account for more than 90% of the world’s insulin supply and the three PBMs that manage pharmacy benefits account for about 80% of Prescription orders were administered. The court argues that, since competition is very limited in both of their markets, these six companies can continue to fix the price list of insulin to the detriment of many patients.

People from low-income families and communities of color are disproportionately affected by the practices of insulin manufacturers and PBMs. According to the California Department of Public Health, Hispanic and Black people more likely to develop type 2 diabetes, the type 2 diabetes mellitus, than non-Hispanic whites, and are more likely to die from complications.

The court finds that the manufacturers are colluding with PBMs to oversell insulin. Manufacturers set drug list prices with PBMs and then negotiate discounts on behalf of health plans. Since rebates are based on a percentage of the list price, manufacturers are increasing their list prices to provide more rebates. they can offer PBMs. PBMs are often billed for their services and a portion of the recovery they negotiate. This motivates the negotiation of a drug with a high reimbursement, not a low price for consumers. As a result, the drug is unaffordable for the uninsured or uninsured, who must pay the full cost of the insulin. The high list price also makes insulin less affordable for other patients, including those with high deductible health plans or limited access.

These unaffordable costs have serious effects on patients’ lives. The California Department of Health and Human Services (CalHHS) reported this year According to national statistics, up to 1 in 4 people with diabetes cannot afford their insulin, and thus have to distribute or stop it altogether. taking insulin. This stock is extremely dangerous and can lead to serious health effects, including death.

Through today’s court, Attorney General Bonta seeks to:

  • Control the high cost of insulin by promoting price competition for insulin and eliminating illegal, unfair, and fraudulent practices; and
  • Reimbursement on behalf of California residents for past drug overpayments.

A copy of the complaint as filed with the court is available here.

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