A group of nineteen pharmacy companies has been named in a lawsuit filed by the Missouri Attorney General, Catherine Hanaway, for allegedly manipulating insulin prices. The lawsuit was submitted to the St. Louis County Circuit Court on January 15, 2024, against various Pharmacy Benefit Managers (PBMs) and drug manufacturers active in Missouri’s healthcare market.
The lawsuit accuses these companies of engaging in deceptive practices that have led to significantly inflated costs for insulin, a vital medication for individuals with diabetes. According to the allegations, over the past fifteen years, these practices have resulted in skyrocketing prices, placing an undue burden on uninsured residents. Approximately 450,000 people in Missouri lack health insurance, with around 18% of that demographic living with diabetes.
Manufactured prices for insulin in Missouri range from $300 to $400, while similar products are available in other countries for less than $5 USD. This discrepancy has left many diabetics reliant on PBMs to secure the most affordable prices for their medication, only to be met with artificially inflated list prices.
“Access to life-sustaining insulin should not be restricted by radical pricing practices that disproportionately harm families,” stated Jeremiah Morgan, Interim Deputy Attorney General. He emphasized that the PBMs have exploited the system for profit, leading to what the lawsuit terms the “Insulin Pricing Scheme.”
The Missouri Pharmacy Business Council, representing independent pharmacists, has expressed support for the lawsuit. They highlighted that the allegations reflect broader issues concerning PBMs, including a lack of transparency and unfair practices that negatively impact both patients and community pharmacies.
The lawsuit names several significant defendants, including:
– Evernorth Health, Inc. (formerly Express Scripts Holding Company)
– Express Scripts, Inc.
– CVS Health Corporation
– UnitedHealth Group, Inc.
– Eli Lilly and Company
– Novo Nordisk Inc.
– Sanofi-Aventis U.S. LLC
As legal action unfolds, Missouri lawmakers are also considering new regulations aimed at increasing transparency in the PBM industry. Senate and House bills, introduced by Sen. Jill Carter and Rep. John Hewkin, respectively, seek to redefine and regulate the practices of PBMs, addressing the pricing disparities that have emerged.
This lawsuit is part of a larger trend, as over 20 states have introduced legislation in the current session to regulate PBMs more tightly. As healthcare costs continue to rise, Missouri’s initiative may set a precedent for other states grappling with similar issues in prescription drug pricing.
The outcome of this lawsuit could have significant implications for how insulin and other essential medications are priced and accessed by patients in Missouri and beyond.