The Hamilton County Board of Commissioners and Prosecutor Connie Pillich have filed suit over the price of insulin. The lawsuit alleges manufacturers Eli Lilly, Novo Nordisk and Sanofi and pharmacy benefits managers CVS Caremark, Express Scripts, and OptumRx unlawfully inflated the price of insulin and diabetes medications.
On Cincinnati Edition we discuss the sharp increase in insulin prices over the years, why the county is filing suit now, and the response from the companies.
Guests:
- Stephanie Summerow Dumas, president, Hamilton County Commission
- Connie Pillich, prosecutor, Hamilton County
Cincinnati Edition and our media partner WCPO reached out to the manufacturers and PBMs and received the following responses:
“Pharmaceutical companies alone are responsible for the prices they set in the marketplace for the products they manufacture. 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.”
CVS Caremark
Novo Nordisk believes that the allegations against it are meritless, and we intend to vigorously defend against these claims. While we will not comment further about pending litigation, we recognize that not all patient situations are the same, and we have a number of different insulin affordability offerings available through NovoCare®. Importantly, we continually review and revise our offerings as well as work with diverse stakeholders to create solutions for differing patient needs.
Novo Nordisk
"While we will not comment on the specifics of the allegations, Sanofi’s pricing practices have always complied with the law and the company is committed to helping patients access the medicine they need at the lowest possible price. Following through on that commitment requires Sanofi to navigate a complex environment. Under the current system, savings negotiated by health insurance companies and PBMs through rebates are not consistently passed through to patients in the form of lower co-pays or coinsurance. As a result, patients’ out-of-pocket costs continue to rise while the average net price of our insulins declines. Sanofi believes that no one should struggle to pay for their insulin, regardless of their insurance status or income level, which is why we have a suite of innovative and patient-centric savings programs to help people reduce their prescription medicine costs."
Sanofi
“In the only three cases where insulin pricing allegations have been put to their proof, the plaintiffs have either dropped their case, lost their motion to proceed as a class action, or settled for no money. These outcomes speak for themselves. Lilly has been working for years to reduce insulin out-of-pocket costs for people with diabetes, against the headwinds of those—like parties filing these lawsuits—that benefit from rebates and choose higher list-price medicines over lower-priced options. Lilly was the first company to cap what patients pay at $35 per month for all of our insulins, we cut insulin prices by 70%, and in 2024 the average monthly out-of-pocket cost for Lilly insulin was less than $15.”
Eli Lilly
"For many years, Optum Rx has aggressively and successfully negotiated with drug manufacturers and taken additional actions to lower prescription insulin costs for our health plan customers and their members, who now pay an average of less than $18 per month for insulin. PBMs, like Optum Rx, are the key counterweight to pharmaceutical companies’ otherwise unchecked monopoly power to set and raise drug prices."
OptumRx
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