“Artificially increasing prices to profit off of people who could die without your product is terrible,” said Attorney General Bird. “Diabetics in Iowa deserve a free and fair marketplace, not a rigged market increasing the price of their insulin. We are suing so Iowans can afford the medicine they need to live and to prevent pharmacy benefit managers and insulin manufacturers from gaming the system at the expense of vulnerable people.”  

Approximately 300,000 Iowa residents are living with diabetes, and an additional 820,000 Iowa residents have prediabetes. Today’s lawsuit asserts that PBMs and insulin manufacturers created and participated in an unlawful pricing scheme that led to both a large increase in the price of insulin while simultaneously increasing the profits of PBMs and insulin manufacturers at the expense of Iowans. This lawsuit asserts: 

• Iowa diabetics have been overcharged millions of dollars a year because of the insulin pricing scheme. 

• The insulin pricing scheme has cut off access to lower priced, affordable insulin formulas and drugs for Iowa diabetics because they were not profitable enough for the PBMs. 

• Unable to afford the drugs they need to survive, many diabetics in Iowa ration or under-dose their diabetes medications, inject expired insulin, reuse needles, and/or starve themselves to control their blood sugars. This behavior is extremely dangerous and can lead to serious complications or even death. 

• Insulin manufacturers have published prices in Iowa of $300-$400 for the same at-issue insulin that was sold in other countries for less than $5.  

The Iowa Attorney General’s office is asking the Court to protect Iowans and enforce state law by: 

• Determining the PBMs and insulin manufacturers have violated and are violating Iowa law and received a financial windfall from their unlawful acts committed at the expense of Iowans. 

• Requiring the PBMs and insulin manufacturers to stop their unfair and deceptive practices and acts, including the insulin pricing scheme. 

• Requiring the PBMs and insulin manufacturers to pay all restitution, damages, reimbursement, and other relief that may be owed to Iowans who were harmed by the unlawful behavior of the PBMs and insulin manufacturers.  

Read the full petition here.   

The list of PBMs and insulin manufacturers being sued is: 

• Eli Lilly and Company 

• Novo Nordisk Inc. 

• Sanofi-Aventis U.S. LLC 

• Evernor Health, Inc. (Formerly Express Scripts Holding Company) 

• Express Scripts, Inc. 

• Express Scripts Administrators, LLC 

• ESI Mail Pharmacy Service, Inc. 

• Express Scripts Pharmacy, Inc.  

• Medco Health Solutions, Inc. 

• CVS Health Corporation  

• CVS Pharmacy, Inc.  

• Caremark Rx, LLC 

• CaremarkPCS Health, LLC 

• Caremark, LLC 

• UnitedHealth Group, Inc.  

• Optum, Inc. 

• OptumRx, Inc.  

• OptumInsight, Inc.