Harris County Attorney Vince Ryan announced Nov. 21 that the county is filing a lawsuit against several companies involved in providing insulin and other treatments to diabetics. The lawsuit alleges that the companies, including pharmaceutical manufacturers Eli Lilly, Novo Nordisk and Sonofie as well as pharmaceutical benefit managers Aetna Rx, CVS Caremark, Express Scripts and Optum Rx conspired to raise insulin prices which have resulted in record profits for those organizations.
“We are bringing this lawsuit to hold these billion-dollar companies responsible for conspiring to drive up the prices of their lifesaving insulin,” Ryan said in a press release.
Harris County’s claim includes violations of the Texas antitrust statute, fraud and civil conspiracy. The County is suing to recover funds the county has paid as a result of the alleged conspiracy between the manufacturers and benefits companies. Harris County is now paying more for insulin and diabetes medications than for any other diseases faced by county employees and their families. Ryan claims in the county’s statement that in 2015, Harris County spent greater than 60% more on diabetes medications than in 2014, and that the county has spent more than $27.5 million on diabetes medications since 2013.
However, pharmaceutical benefit managers – or PBMs – named as defendants in the suit deny the accusations against them.
“Allegations that CVS Caremark or Aetna [Rx] play any role in determining the prices charged by manufacturers for their products are false,” Senior Director of Corporate Communications for CVS Caremark Michael DeAngelis said via email.
Pharmaceutical benefit managers, commonly called PBMs in the industry, work to keep drug prices low to obtain lower drug prices for customers through negotiating with manufacturers and using formularies to keep drug costs low for patients, DeAngelis said. These negotiations help mitigate the rising costs of diabetic care, and nothing in PBMs agreements with drug manufacturers prevent drug manufactures from lowering their prices, he said.
Eli Lilly and Company cannot comment directly on pending litigation said Gregory Kueterman, senior director of diabetes communications for Eli Lilly and Company. However, he said the company has been working to ensure insulin is affordable for patients.
“Today, the vast major of people using Lilly insulin pay less than $100 for their monthly prescription. In fact, more than 95 percent pay $95 or less for their monthly prescription of Humalog, our most commonly used insulin,” Keuterman said.
Eli Lilly founded the Lilly Diabetes Solution Center in August of 2018 to help patients afford their diabetes medications. Through the program, diabetes patients can obtain the insulin drug Humalog for $95 a month. The $95 is the out of pocket expense for a patient regardless of whether they have health insurance or not. The Solution Center also helps connect patients at about 150 free clinics that carry donated Eli Lilly insulin nationwide.
Some patients are also eligible to receive free insulin through Lilly Cares, a separate Eli Lilly nonprofit, Keuterman said. Patients are eligible for that assistance if they make four times the federal poverty level or less, he said.
Despite Eli Lilly’s nonprofit efforts, Harris County is claiming that insulin, which sold for about $20 per vial in the late 1990s is now selling for as much as $700 a vial, but costs only about $5 to produce.
“The discoverers sold the original patent for $1 to ensure that the medication would remain affordable,” Ryan said. “Today, insulin has become the poster child for pharmaceutical price gouging.”
Of the seven defendants, four did not respond to Katy Times inquires in time for publication of this article and Express Scripts declined to comment. DeAngelis responded on behalf of both CVS Caremark and Aetna Rx.