Bucks County officials announce lawsuit accusing drug giants of ‘illegal price fixing’ for insulin

Bucks County officials announced they are suing major insulin manufacturers and companies that negotiate drug price deals for insurers over an “illegal price-fixing scheme.”

“Manufacturers and middlemen have rigged America’s drug-pricing system, making insulin incredibly expensive for families covered by our county health plan,” said Bucks County Solicitor Amy Fitzpatrick during a Friday news conference in Doylestown.

The lawsuit, filed in U.S. District Court in the District of New Jersey, alleges that Bucks County, which offers health coverage to its more than 2,000 employees, pays excessively high prices for insulin and other diabetes medications. Pharmacy benefit managers CVS Caremark, Express Scripts, and OptumRx are listed as defendants, as are insulin manufacturers Eli Lilly and Co., Novo Nordisk, and Sanofi.

Fitzpatrick announced the lawsuit alongside Bucks County’s two Democratic commissioners, Bob Harvie and Diane Ellis-Marseglia, as well as Bucks County District Attorney Jennifer Schorn.

Insulin and most other drugs cost more than twice as much in the United States when compared with other developed countries. The drug is crucial for many of the 38.4 million Americans living with diabetes, and in some cases, grassroots health organizations estimate drug companies introduced price markups of as much as 5,000% from the actual cost of manufacturing.

In the run-up to the 2024 election, former President Joe Biden frequently touted his administration’s cap on insulin prices at $35 for Medicare patients. Just this week, President Donald Trump signed an executive order aiming to reduce high prescription drug costs by ordering drug companies to cut prices to the lower rates other countries pay, though it remains unclear how that would work.

The Pharmaceutical Care Management Association, an industry group representing pharmacy benefit managers, responded to recent scrutiny by saying that criticisms ignore progress companies have made to lower insulin costs, and that they fail to take into consideration the role of the entire prescription drug supply chain.

In Bucks, Fitzpatrick rattled off a series of statistics justifying the county’s legal action.

Pharmacy benefit managers act as middlemen between insurers and manufacturers. They manage drug plans for insurers, negotiating drug prices and deciding which medications will be covered under the plans.

The three pharmacy benefit managers named in the lawsuit control 80% of the market for more than 270 million Americans, according to the solicitor. The scope of that control has “eliminated meaningful competition” for cheaper options, Fitzpatrick said, while allowing those companies to demand higher rebates from manufacturers that further drive up prices.

Ellis-Marseglia, for her part, said that she would rather see the “millions” in taxpayer dollars Bucks County pays for insulin used to fund affordable housing projects, first responders, and mental health treatment.

Her counterpart, Harvie, underscored the disparities between U.S. insulin costs and other countries, citing statistics showing that residents pay up to six times more for the drug than those in Mexico and up to 18 times as much as those in Poland.

“Someone has to stand up to companies who are causing this pain,” Harvie said.

Asked about the intended goal of the lawsuit, Harvie said “what we expect is for prices to come down, not just for Bucks County residents and families.”

Harvie said impetus for the lawsuit came around two years ago under former Bucks County Solicitor Joe Khan. As other cities and counties continue to enter their own insulin-related litigation, this is “when the pieces fell into place.”

Philadelphia District Attorney Larry Krasner introduced a lawsuit last year that names the same major pharmacy benefit managers and manufacturers, alleging collusion over insulin pricing and seeking unnamed monetary damages and an end to the practice. The defendants said in response that the lawsuit is baseless and should be dismissed.

Elsewhere, the state of Minnesota won a settlement in its suit against Eli Lilly, successfully capping insulin prices for state residents in coming years.

Schorn, the district attorney, told of Bucks County residents both young and old for whom insulin is a lifesaving medication, using the example of a mother and her son, who has diabetes and relies on the drug.

People with Type 1 diabetes do not produce insulin, a hormone that controls blood sugar levels, while people with Type 2 diabetes have trouble regulating their body’s insulin. Without supplemental insulin, people with diabetes can experience dangerously high blood sugar levels, leading to organ and nerve damage.

“Why has insulin become privileged in this country?” Schorn said. “Insulin is not a luxury, it is life support.”

This is not Bucks County’s first effort to use litigation as a means to combat nationwide problems.

In 2018, the county joined governments across the country in successfully suing major opioid manufacturers and distributors to recover damages from the addictive prescription drugs’ devastating impact on surrounding communities.

Bucks officials have since sued social media companies for what they said are practices that harm county youths as well as major oil companies for their role in accelerating the climate crisis.