State Attorney General Dave Sunday’s office claims that more than a dozen pharmaceutical companies and pharmacy middlemen worked together to “artificially” inflate insulin prices by more than 1,000%.
“Millions of Pennsylvanians have diabetes or prediabetes and they were all potentially harmed by this scheme to artificially inflate pricing to maximize company profits,” Sunday said in a release. “Our Antitrust Section will continue to hold accountable companies, large and small, that prioritize profits over public access to affordable life-saving medication and care.”
Tuesday’s lawsuit, filed in the Commonwealth Court of Pennsylvania, accuses manufacturers such as Eli Lilly and Company, Novo Nordisk, Inc. and Sanofi-Aventis US LLC of working with pharmacy benefit managers (PBMs) such as Express Scripts, CVS Caremark and Optum RX to increase prices.
PBMs operate as brokers between manufacturers, distributors and pharmacies, with a role under increasing scrutiny from lawmakers, regulators and critics — some of whom claim their existence adds to increasing drug prices.
The three biggest PBMs, all parties to the lawsuit, manage roughly 80% of all prescription drug claims in addition to being owned by parent companies overseeing major insurance or pharmacy companies, setting up potential conflicts of interest.
Sunday is the latest state attorney general to sue over insulin prices — a list that includes 2026 lawsuits filed in both Oregon and Florida. Earlier this year, the Federal Trade Commission announced settlement agreements with Caremark and Express Scripts after the agency accused three PBMS of driving up list prices.
The case against the third PBM, Optum, was withdrawn to consider a proposed consent agreement, according to the agency.
In most cases, insulin costs no more than $35 per month, but many still report rationing their medication. Without insulin or proper management, people can develop kidney failure, require amputation or die.
Sunday’s lawsuit seeks injunctive relief, changes to force lower prices and restitution for harmed Pennsylvanians.
