Drugmakers and intermediaries accused of price-fixing in a University of Pennsylvania lawsuit, causing insulin prices to skyrocket excessively
In a significant development, multiple lawsuits are currently underway against major U.S. drugmakers and Pharmacy Benefit Managers (PBMs) over allegations of price-fixing for insulin and other diabetes drugs. These lawsuits, consolidated in multidistrict litigation, are actively ongoing as of mid-2025.
At the heart of these legal proceedings are defendants such as Eli Lilly, Novo Nordisk, Sanofi, CVS Caremark, Express Scripts, and OptumRx. The University of Pennsylvania filed a federal lawsuit on July 11, 2025, accusing these companies of colluding to artificially inflate insulin prices over a two-decade period. The defendants have denied these allegations.
The lawsuits claim that the pharmaceutical companies and PBMs engaged in a complex scheme involving shadow pricing and rebates to keep insulin prices exorbitantly high. As a result, insulin list prices have risen more than 1,000% since the late 1990s. PBMs are alleged to have misused their intermediary role by securing rebates from manufacturers, which then inflate the list prices that patients ultimately face.
Government entities, including state attorneys general and the Federal Trade Commission (FTC), are also involved. Notably, on July 14, 2025, the FTC filed a lawsuit against the three largest PBMs—Caremark, Express Scripts, and OptumRx—and their group purchasing organizations, accusing them of anticompetitive rebating practices that artificially inflated insulin prices.
The scope of the litigation is vast, involving not just insulin but also other diabetes drugs like Ozempic (manufactured by Novo Nordisk). By July 2025, nearly 2,000 lawsuits had been filed in multidistrict litigation.
While the defendants have denied the allegations, some pharmaceutical companies have faced legal setbacks. For instance, Eli Lilly has won three cases where insulin pricing allegations have been put to their proof, either dropping the case, losing the motion to proceed as a class action, or settling for no money.
The high cost of diabetes drugs is a pressing concern, given that about 38.4 million people in the U.S. suffered from diabetes in 2024, according to the U.S. Centers for Disease Control and Prevention. The University of Pennsylvania's Penn Health System, one of the city's top five employers, is among those affected.
The lawsuits are not just isolated incidents. They represent a significant ongoing legal challenge to drugmakers and PBMs accused of exploiting their market control to make life-saving diabetes drugs unaffordable for millions in the U.S. The outcome of these lawsuits could have far-reaching implications for the pharmaceutical industry and the millions of Americans who rely on these drugs.
- The ongoing multidistrict litigation, including the University of Pennsylvania's federal lawsuit, targets pharmaceutical companies such as Eli Lilly, Novo Nordisk, Sanofi, CVS Caremark, Express Scripts, and OptumRx, accusing them of artificially inflating insulin prices and engaging in anticompetitive practices, affecting not only the health-and-wellness sector but also the finance and business aspects of these companies.
- Amidst the rising medical-conditions like diabetes, spanning across a two-decade period, the high cost of diabetes drugs, such as insulin and Ozempic, has been subjected to numerous lawsuits by government entities and individuals alike, with the aim of addressing the issue of price-fixing and ensuring affordable health-and-wellness solutions for millions of Americans, potentially reshaping the pharmaceutical industry and its business practices.
