Jefferson and Temple join wide-ranging litigation over high insulin pricing
The move follows similar suits from the University of Pennsylvania, the city of Philadelphia, Philadelphia District Attorney Larry Krasner, and Bucks County.
Temple University Health System and Jefferson Health are the latest area health systems to sue pharmaceutical companies and pharmacy benefit managers over high insulin pricing.
The move follows similar lawsuits filed in recent years by the University of Pennsylvania, the city of Philadelphia, Philadelphia District Attorney Larry Krasner, and Bucks County, as well as hundreds of other municipalities, companies, and unions around the country.
Temple filed its suit last week, and Jefferson sued just before the new year.
Eli Lilly, CVS Caremark, and Sanofi are among the major companies named in the suits, which accuse drugmakers and pharmacy benefit managers, or PBMs, of conspiring to drive up profits on diabetes drugs.
PBMs work with drug manufacturers, insurers, and pharmacies, negotiating prices and developing formularies — lists of prescription drugs that are available on a given insurance plan.
The health systems and other plaintiffs say drugmakers inflate prices for their insulin products in order to secure lucrative placements on formularies. Then, they pay a portion of the resulting profits back to PBMs, according to the lawsuits.
Jefferson and Temple officials said they are paying more for employees’ insulin as a result, impacting the health systems’ budgets and hurting their ability to “provide necessary services [...] to the larger Philadelphia community.”
Representatives from both health systems declined to comment.
Eli Lilly has worked for years to reduce out-of-pocket costs for insulin, the company said in a statement, noting that some plaintiffs filing the lawsuits are choosing higher-priced medications over more affordable options.
Lilly capped insulin prices at $35 per month, the statement said, and in 2024 the average monthly out-of-pocket cost for its insulin was less than $15.
CVS Caremark said pharmaceutical companies “alone are responsible” for pricing their drugs in its latest statement, released after Philadelphia officials joined the litigation last month. The company said it would welcome lower prices on insulin.
“Allegations that we play any role in determining the prices charged by manufacturers for their products are false, and we intend to vigorously defend against this baseless suit,” they wrote in an email.
A statement from Sanofi said that the company has always complied with the law when it comes to drug prices and works to lower prices. PBMs and insurers sometimes negotiate savings on drugs, but those are “not consistently passed through to patients in the form of lower co-pays or coinsurance,” the statement read.
“As a result, patients’ out-of-pocket costs continue to rise while the average net price of our insulins declines.”