Massachusetts Attorney General Andrea Joy Campbell has filed a lawsuit in Suffolk Superior Court against leading insulin manufacturers Eli Lilly, Sanofi, and Novo Nordisk, along with pharmacy benefit managers (PBMs) Optum RX, Express Scripts, and CVS Caremark. The suit alleges the companies engaged in unfair and deceptive practices to inflate insulin prices, harming diabetic patients in the state.

According to the complaint, the PBM defendants collaborated with the manufacturers to manipulate the market for diabetes treatments, leading to exorbitant price increases. Over the last decade, the manufacturers have allegedly raised insulin prices by as much as 1,000%.

“Insulin manufacturers and pharmacy benefit managers worked together to drive up prices and exploit vulnerable diabetes patients,” said AG Campbell. “This lawsuit seeks to hold these companies accountable for their greed and protect consumers from excessive health care costs.”

Massachusetts legislators praised the Attorney General’s actions. Senator Cindy Friedman highlighted the ongoing need for transparency in drug pricing, noting recent legislative efforts to cap out-of-pocket insulin costs and introduce oversight measures. Representative John Lawn emphasized the importance of addressing the opaque practices of PBMs, which contribute to rising drug prices and limited consumer transparency.

The AG’s complaint reveals that synthetic insulin, initially priced at $20 in the late 1990s and costing manufacturers less than $2 to produce today, now carries a price tag of $300 to $700. In Massachusetts, an estimated 500,000 residents live with diabetes, and another 1.8 million have prediabetes. High insulin costs force many diabetics to ration their medication, use expired insulin, reuse needles, or skip meals to manage their blood sugar levels.

The lawsuit alleges that insulin manufacturers intentionally inflated prices and returned significant, undisclosed payments to PBMs in exchange for preferential placement in PBM formularies. These formularies, which determine drug availability, out-of-pocket costs, and restrictions, often prioritize higher-priced drugs while excluding more affordable alternatives. The PBMs, controlling 80% of the pharmacy benefit market, falsely claimed to lower drug prices while actively driving up costs in collaboration with manufacturers.

The Attorney General’s Office argues that these practices violate the Massachusetts Consumer Protection Act and constitute unjust enrichment and unlawful civil conspiracy. The lawsuit seeks restitution for affected consumers, penalties for the defendants, and a permanent injunction to prevent further unfair and deceptive practices.

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