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States and Prosecutor Demand Information About Insulin Drug Price Increases

Over the past decade, prices for lifesaving insulin drugs have skyrocketed. Between 2002 and 2013, the average price of insulin almost tripled, according to the American Diabetes Association. These price hikes are causing immense hardship for patients. But antitrust authorities and state governments, frustrated with federal inaction, are demanding information from drug companies and pharmacy benefit managers (PBMs) about how they contribute to higher drug prices.

Back in March 2016, the U.S. Attorney's Office for the Southern District of New York launched a civil investigative demand. They asked for information on the insulins Novolog, Novolin, Lantus, and Levemir, and wanted facts from both the drug manufacturers and PBMs. In August 2016 the office sent a civil investigative debate to the PBM Express Scripts, asking for information about their relationships with drug manufacturers. And in November 2016 Senator Bernie Sanders and Representative Elijah Cummings, who have both been very active on reducing drug prices, sent a letter asking the Department of Justice and the Federal Trade Commission to investigate whether insulin manufacturers engaged in collusion or other anti-competitive behavior to keep prices high.

At the beginning of this year, in January 2017, Minnesota's Attorney General began an investigation of Sanofi and Novo Nordisk; the state wanted evidence about pricing and trade practices for the insulins Levemir and Tresiba. Shortly thereafter a lawsuit was filed against insulin makers, alleging "an organized scheme to drive up prices at the expense of patients who need insulin drugs to live." In March 2017 Washington State's Attorney General sent a similar request, and more patients filed suit against insulin manufacturers, and against the PBMs Express Scripts, CVS Health, and United Health Group. They alleged that PBMs sell access to their formularies by demanding that drug manufacturers offer not the lowest prices but the highest rebates.

And in April, patients filed a similar lawsuit in New Jersey. New Mexico sent a civil investigative demand to Eli Lilly about the pricing of their insulin drugs. More recently, in July 2017 CVS got a civil investigative demand from Minnesota's Attorney General, and Senator Amy Klobuchar sent letters to insulin manufacturers asking for an "explanation of the extreme price increases" of insulin.

Finally, in September 2017, U.S. District Judge Brian Martinotti appointed Steve Berman and James Cecchi as interim lead counsel over a suit that combines the various civil lawsuits filed since the beginning of 2017 into one gigantic suit.

Patients, legislators, and antitrust authorities want answers on how insulin manufacturers and PBMs contribute to higher drug prices, and they deserve to get them.

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