Missouri has filed a lawsuit against nearly two-dozen pharmacy benefit manager companies, claiming that PBMs and pharmaceutical manufacturers worked together to manipulate market prices for insulin, leading to “skyrocketing prices” for the life-saving medication.
“At a time when health care costs continue to soar, we are taking a stand against insulin price manipulation and fraud,” Missouri Attorney General Catherine Hanaway said in a press release. “It is quite clear that the health care administration conglomerates do not want the prices for diabetes medications to go down, choosing profit over affordable health care for people at risk. Missourians deserve a fair and just marketplace and we demand nothing less.”
Hanaway’s office claims that the “Insulin Pricing Scheme” has had a disproportionate impact on uninsured residents. Of the nearly half-million Missourians without health insurance, about 18% have been diagnosed with diabetes and require insulin or other medication.
“Notably,” the attorney general’s office said, “manufacturers published prices in Missouri of $300-$400 for the same at-issue drugs that were sold in other countries for less than the equivalent $5 USD. Missouri diabetics rely on the PBMs to achieve the lowest prices for insulin and to construct formularies designed to improve their health and lower costs, only to be deceived with artificially inflated list prices.”
“Access to life-sustaining insulin should not be restricted by radical pricing practices that disproportionately harm families,” Missouri Interim Deputy Attorney General Jeremiah Morgan said in a statement. “PBMs have found a way to game the system for their mutual benefit—the Insulin Pricing Scheme, and consumers have said ‘enough.’”
The Missouri Pharmacy Business Council has since issued a statement in support of the lawsuit.
In it, the council said that many pharmacists have found themselves frustrated with how PBMs manipulate markets in their favor, making it substantially more difficult for pharmacies and customers to get fair prices.
“Independent pharmacists dedicated to fair practices related to prescription drug pricing and access enthusiastically support Missouri Attorney General Hanaway and the state’s lawsuit against 19 pharmacy benefit managers (PBMs) accused of manipulating pricing and access to insulin for vulnerable patients with diabetes,” the Missouri Pharmacy Business Council said.
“Independent pharmacists see firsthand how greed – not patient care – drives the PBM industry to manipulate the system in their favor alone,” the group said. “This insulin scheme is just one example of broader PBM abuses including opaque pricing, pharmacy steering, lack of transparency, and retaliatory audit practices that harm patients and community pharmacies alike.”
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Missouri AG sues pharmacy benefit managers over insulin pricing
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