The Missouri attorney general’s office has filed a lawsuit against 19 pharmacy benefit managers and drug manufacturers, alleging they conspired to inflate insulin prices and deceive consumers.
The lawsuit claims the defendants engaged in deceptive and unfair practices that caused life-sustaining insulin prices to soar in the state, according to court documents. The lawsuit, filed in St. Louis County Circuit Court, claims some manufacturers listed insulin at $300 to $400 per vial in Missouri, while selling the same drugs abroad for less than $5. Nearly 450,000 Missouri residents are uninsured, and approximately 18% of them are diabetic.
The complaint invokes the Missouri Merchandising Practices Act and seeks to declare the pricing scheme unlawful, halt the conduct and recover restitution for consumers. Eli Lilly, Novo Nordisk, Sanofi, CVS Health, Express Scripts and OptumRx are among the defendants.
In a statement shared with Becker’s, a Lilly spokesperson called the lawsuit “wasteful” and said the company has “led the way in making insulin more affordable,” citing its 70% price cut, $35 monthly cap, and an average out-of-pocket cost below $15 in 2024. “Lilly is confident in the strength of our legal position,” the spokesperson said.
CVS and Sanofi both declined to comment further but referred Becker’s to previous statements made in response to similar lawsuits, which they said remain applicable to the Missouri case. CVS has said manufacturers alone set drug prices and called the lawsuit “baseless,” while Sanofi has said its pricing complies with the law and pointed to systemic rebate issues that prevent negotiated savings from reaching patients.
Missouri joins a growing number of states taking legal action over insulin pricing. Delaware, Indiana and Oregon have filed similar lawsuits against many of the same companies. The Oregon lawsuit seeks $900 million in damages, while Delaware’s attorney general accused the companies of raising insulin prices by up to 1,000% over 15 years.
