Minnesota brings federal lawsuit over rising insulin prices

Some people with diabetes forced to pay out-of-pocket dangerously ration the drug

Sloane Martin
October 16, 2018 - 1:43 pm
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Minnesota Attorney General Lori Swanson has filed a lawsuit against three pharmaceutical companies over the rising cost of insulin.

It alleges Sanofi, Novo Nordisk and Eli Lilly fraudulently set list prices of the life-sustaining substance, then negotiated a lower actual price by paying rebates to pharmacy benefit managers to get the product featured prominently in health plans. 

"It creates this really perverse pricing scenario where the cost of the drug spirals ever higher, that list price, so that the rebates can be even bigger, so that the PBMs will, in fact, put the product on their drug formulary," Swanson said.

The formulary is a list of approved drugs policyholders can use, and companies want their products on the formulary because it means the drugs will be covered. According to the lawsuit, the public isn't able to know the true cost of insulin. 

Dr. Victor Montori is an endocrinologist with the Mayo Clinic and says he’s seen people ration their insulin and their meals to survive. 

"To have the opportunity, the tool that allows you that, which in this case is insulin, to be dangled in front of you, and then be priced out — you can call it unethical. I call is fundamentally cruel," he said.

Montori says people who can't afford insulin sometimes don't tell their healthcare providers or even their families due to shame or other circumstances. It takes as little as four days for a diabetic person without insulin to need emergency care and it can be fatal. In one case, 26-year-old Alec Smith of Minneapolis died while rationing his insulin when he couldn't afford a $1,300 refill.

One product, Lantus, increased seven-fold from 2009 to 2015, but the price increases starting creeping up in 2001 for some drugs.

Nearly 1 in ten Minnesotans has diabetes and experts say many of them are paying thousands out of pocket if they're uninsured or have a high-deductible plan. Amanda Swanson, 33, who's not related to the attorney general, said she's had to make tough decisions as Type 1 diabetic.

"It's hard to balance between having a family and deciding whether I should spend $500 every three months to get my sensor and my pump and insulin supplies or put groceries on the table," she said.

Swanson, who's leaving office in January, says she hopes the next attorney general maintains the litigation. The lawsuit seeks unspecified monetary and injunctive relief.