Keller Rohrback was among the first firms in the Country to sue pharmacy benefit managers for conspiring with insulin manufacturers to drive up the cost of insulin for American consumers. These abusive practices continue today, and they increase the costs that cities and counties pay for insulin.
Keller Rohrback is investigating the specific impact of the insulin price manipulation on city and county governments, which rely on taxpayer dollars for their purchasing power. In particular, the extent to which the PBMs—insurance industry middlemen who negotiate drug prices and create drug “formularies” that determine how much patients pay—conspired with the insulin manufacturers to artificially inflate the price of insulin for their own collective benefit. This profit-seeking move has directly injured individual patients and other purchasers of insulin financially and put the lives of millions of diabetes sufferers at risk.
Among the purchasers of insulin are scores of city and counties across the country responsible for obtaining the widely-used drug. Insulin is in a unique group of products that is essential for survival and must be used continuously for the life of the patient. The scheme that these public-interest buyers have been exposed to involves PBMs selling exclusionary or preferential access to their formularies, i.e., ranked lists of drugs that health insurers rely upon to determine how much of their members’ drug costs they will cover. Manufacturers’ sales depend on access to these enormous purchaser pools for their profits.
The PBMs and insulin manufacturers game the system. Instead of competing on price for access to the PBMs’ formularies, the manufacturers compete based on the amount of the rebate and other fees that they pay to the PBMs. To prevent the rebates and other fees—and the wasteful transactional costs created by an increasingly convoluted system of payments—from cutting into their profits, the manufacturers raise what they call the “list” price of insulin. Meanwhile, considerable rebates to PBMs maintain at a steady point the “net” price actually realized by the manufacturers. The higher the “list” price, the higher the rebate and other fees, and the larger the profit to the PBMs. The result is a vicious cycle of “list” price increases by manufacturers, vying to win the favor of the PBMs.
If your city or county has purchased the well-known and widely prescribed analog insulins: Lantus, Apidra, Levemir, Humalog, or Novolog, produced by Sanofi-Aventis, Novo Nordisk, or Eli Lilly, you may be paying artificially inflated prices. Contact our attorneys to learn more about whether you too have been subject to unlawful pricing. Call (800) 776-6044 or email [email protected].
At Keller Rohrback, we believe that “Big Pharma” should be held accountable for its abuses, and we’re doing our part to make that happen. We’ve successfully brought cases that returned hundreds of millions of dollars to consumers and health plan payors who have overpaid for prescription drugs due to misconduct, and we’re continuing to use the legal system to represent consumers and health plans in actions where abuses have been identified.
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