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AG Bird Sues PBMs and Insulin Manufacturers over Alleged Pricing Scheme

  • Iowa AG Brenna Bird filed a lawsuit against multiple pharmacy benefit managers (PBMs) and insulin manufacturers, alleging the companies violated Iowa’s Consumer Fraud Act by artificially inflating diabetes drug prices for Iowa consumers.
  • According to the petition, the PBMs and manufacturers allegedly engaged in an unlawful pricing scheme that substantially increased the price of insulin for Iowans.
  • The AG’s office claims the list prices set by manufacturers were untethered from net prices and costs, while the PBMs allegedly leveraged formulary placement and exclusions to favor higher-list price drugs, which in turn drove up costs for consumers and limited access to lower-price alternatives.
  • The petition further alleges that PBMs profited through opaque contracting practices that allowed them to retain manufacturer payments through affiliated rebate entities and then keep the difference between amounts charged to payors and amounts reimbursed to pharmacies.
  • Iowa seeks injunctive relief, consumer reimbursement and restitution, disgorgement, damages, civil penalties, and costs.
  • As we have reported, AG Bird’s action is the latest in a series of actions by State AGs over the pricing of insulin, including Kansas, Mississippi, Minnesota, New York, New Mexico, Maine, and Virginia.