Arlington-based Texas Health Resources is suing six drugmakers and pharmacy benefit managers, alleging the parties colluded to drive up the price of insulin, according to court documents obtained by Becker’s.
The nonprofit system filed the federal lawsuit March 26 in New Jersey District Court against Express Scripts, CVS Caremark, Optum Rx, Sanofi, Eli Lilly and Novo Nordisk.
The suit alleges the defendants colluded to raise insulin prices by as much as 1,000% over two decades — far outpacing inflation and production costs — while pocketing secret rebates and fees.
Texas Health Resources claims it has paid inflated prices for diabetes medications since 2005 through its self-funded insurance health plan, which covers about 40,000 beneficiaries. The health system further alleges it was directly harmed by the allegedly fraudulent list prices and formulary decisions, which it claims violate the federal Racketeer Influenced and Corrupt Organizations Act, Texas consumer protection laws and other state statutes.
The health system is seeking unspecified damages. Texas Health Resources joins more than 400 other entities that have filed similar lawsuits against the defendants, according to the Denton Record-Chronicle.
Becker’s reached out to the defendants for comment and received the following responses on April 15:
- CVS Caremark called the lawsuit “baseless” and said drugmakers alone set insulin prices. “Allegations that we play any role in determining the prices charged by manufacturers for their products are false,” a spokesperson said, noting that its members pay less than $25 on average for insulin.
- “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,” a spokesperson for Sanofi told Becker’s.
- Novo Nordisk called the allegations “meritless,” saying it intends to “vigorously defend against these claims.” The company added that it offers various insulin affordability offerings for patients.
- Optum Rx told Becker’s the lawsuit reflects “a profound misunderstanding of how drug pricing works” and said that PBMs serve as “the key counterweight to pharmaceutical companies’ otherwise unchecked monopoly power.” The PBM said its health plan customers and members pay less than $18 per month on average for insulin.
- Eli Lilly said the “copycat lawsuits” were “baseless,” pointing to previous cases that were dropped, denied class-action status or settled without payment. “These outcomes speak for themselves,” a spokesperson told Becker’s. Eli Lilly noted that it was the first to cap monthly out-of-pocket insulin costs at $35. In 2023, this average cost for customers was $17.16.
Editor’s note: Becker’s will update the article if it receives comment from additional defendants.
