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The Alvarez Law Firm is dedicated to advocating for those affected by these injustices, providing expert legal representation to ensure that individuals and health plans receive the compensation they deserve. With a commitment to fighting for fair healthcare practices, The Alvarez Law Firm aims to bring about meaningful change in the pharmaceutical industry. Contact us today to schedule your consultation and learn more about how we can help.

What is Insulin, and Why is it Important?

Insulin is a hormone produced by the pancreas that plays a crucial role in regulating blood sugar (glucose) levels. It helps cells throughout the body absorb glucose from the bloodstream to use as energy or store for later use. Without adequate insulin, glucose remains in the bloodstream, leading to high blood sugar levels, which can result in various health complications.

Types of Diabetes

Two main types of diabetes impact insulin function:

  • Type 1 Diabetes: This is an autoimmune condition where the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. People with Type 1 diabetes require external insulin to manage their blood sugar levels.
  • Type 2 Diabetes: In this condition, the body becomes resistant to insulin, or the pancreas does not produce enough insulin. Type 2 diabetes can often be managed with lifestyle changes, but many individuals eventually require insulin therapy to control their blood sugar levels.

Importance of Insulin

  • Blood Sugar Regulation: Insulin helps to keep blood sugar levels within a healthy range. Proper regulation is critical to preventing complications such as cardiovascular disease, nerve damage, kidney damage, and vision problems.
  • Energy Supply: By allowing glucose to enter cells, insulin ensures the body has a steady energy supply for daily functions and physical activity.
  • Preventing Complications: Consistent insulin therapy helps prevent both short-term and long-term complications of diabetes. High blood sugar levels can lead to severe conditions such as diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome, as well as chronic complications like neuropathy, retinopathy, and nephropathy.
  • Quality of Life: Effective insulin management is essential for maintaining overall health and well-being. It helps individuals with diabetes lead an everyday life, participate in daily activities, and reduce the risk of serious health issues.

Challenges and Access Issues

Insulin prices have surged despite a decrease in production costs due to more efficient manufacturing. A 2018 study indicated that a fair annual price for human insulin should be between $48 and $71, allowing manufacturers to still profit significantly. Another study suggested that insulin companies could remain profitable by pricing vials under $2. However, in 2016, the average diabetic spent about $5,705 on insulin.

A 2018 study by the American Diabetes Association revealed that in 2017, the rising cost of insulin led to various behavioral adjustments among users, as detailed below:

  • 26% frequently took less than the prescribed dosage
  • 23% missed 1-2 doses each week
  • 20% missed 1-2 doses each month
  • 20% utilized a patient assistance program
  • 20% engaged with discount drug programs or websites
  • 18% did not fill at least one insulin prescription
  • 17% used a coupon or rebate

The study also highlighted that these changes in behavior due to insulin costs led to a variety of health, lifestyle, and emotional consequences, including:

  • Experiencing illness or severe illness
  • Feeling sluggish
  • Elevated blood sugar levels
  • Inability to engage in activities
  • Challenges in maintaining a proper diet
  • Increased anxiety
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Since the 1990s, insulin innovation has stagnated, funneling most profits into marketing rather than research and development. For instance, Eli Lilly invested $395 million in R&D from 2014 to 2018 but spent $1.5 billion on marketing, generating $22.4 billion in revenue. Similarly, Sanofi spent $902 million on insulin R&D while earning around $37 billion in net sales.

These practices have led to concerns about corporate greed driving up insulin prices. In response, patients and advocacy groups have filed lawsuits against insulin manufacturers for price gouging and unethical practices that prioritize profits over patient needs.

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Insulin Overpricing Lawsuit: Seeking Justice for Inflated Drug Costs

The Basis of the Lawsuits

The lawsuits against insulin manufacturers center on several vital allegations:

  • Price-Fixing: Plaintiffs claim that pharmaceutical companies have colluded to artificially inflate insulin prices. This alleged price-fixing has made it difficult for patients to afford their medication, leading to financial strain and health risks.
  • Kickbacks and Rebates: The lawsuits argue that insulin manufacturers have provided significant rebates and kickbacks to pharmacy benefit managers (PBMs) in exchange for favorable placement on insurance formularies. This practice is believed to have contributed to the inflated insulin costs for consumers.
  • Lack of Transparency: Insulin pricing is vague and unclear, making it challenging for patients and healthcare providers to understand the drug's actual cost. The lawsuits contend that this opacity allows manufacturers to manipulate prices without accountability.

Potential Compensation That Can Be Recovered in an Insulin Overpricing Lawsuit

  • Refunds for Inflated Prices: Claimants may receive compensation for the excess costs incurred due to inflated insulin prices. In some cases, damages could be tripled to both reimburse victims and deter future misconduct by the defendants and others.
  • Injunctive Relief: This would stop the current insulin pricing practices, protecting self-funded plans and their members from future financial harm.
  • Disgorgement of Profits: PBMs and manufacturers may be required to return illicit profits gained from overpricing.
  • Punitive Damages: These damages aim to punish past misconduct and prevent similar actions in the future.

Legal Actions and Progress

We are filing legal claims against PBMs and insulin manufacturers for their misconduct, including violations of RICO, deceptive and unfair trade practices, and unjust enrichment, among other potential issues.

Our goal is to seek monetary damages and restitution for the inflated insulin prices that self-funded healthcare plans and their members have already paid while also working to prevent these rates from being charged in the future.

How to Join the Insulin Overpricing Lawsuit

Determine Eligibility

Before taking any legal action, you should determine if you are eligible to join the lawsuit. Generally, you may qualify if you:

  • Are a diabetic patient who has paid for insulin out-of-pocket or through insurance
  • Are part of a self-funded health plan that has incurred increased costs due to high insulin prices
  • Represent a health plan or organization whose inflated prices have financially impacted

Gather Documentation

Collect all relevant documentation to support your claim, including:

  • Receipts and invoices for insulin purchases
  • Insurance statements showing out-of-pocket costs
  • Correspondence with your insurer or PBM regarding insulin prices
  • Medical records confirming your diabetes diagnosis and need for insulin

Consult a Lawyer

Find an attorney specializing in pharmaceutical litigation, antitrust law, or consumer protection. They can:

  • Evaluate your case and determine the best course of action
  • Explain your rights and options for joining an existing lawsuit or filing a new one
  • Guide you through the legal process and handle all necessary paperwork
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Litigation Updates

February 2024

On February 7, 2024, a settlement was filed in the U.S. District Court for the District of New Jersey, where Eli Lilly & Co. agreed to limit the price of insulin to $35 per month for Minnesota residents with prescriptions. This settlement, pending approval, stems from a lawsuit regarding insulin pricing that has been ongoing since 2018. It is set to last for five years and includes provisions aimed at enhancing accessibility and making donations to clinics.

January 2024

The case numbered 2:24-cv-27 from the District of Utah has been transferred to the District of New Jersey and assigned the civil action number 24-cv-536 in the matter of In Re: Insulin Pricing Litigation, MDL 3080.  

December 2023

On December 7, 2023, the Levin Papantonio Rafferty (LPR) law firm announced that Attorney Troy Rafferty has been appointed as Co-Lead Counsel for the State Attorney General Track, while Attorney Brandon Bogle has been designated as Co-Lead Counsel for the Self-Funded Payer Track in the multidistrict litigation regarding insulin pricing (MDL No. 3080).  

The State Attorney General Track will cover legal actions taken on behalf of states, whereas the Self-Funded Payer Track will focus on individual actions representing self-funded payers or groups, including local governments, schools, and non-profit organizations that cover prescription drug costs for their members.  

November 2023

On November 27, 2023, all parties involved in the MDL submitted their recommendations for the selection of Lead Counsel, the Executive and Steering Committees, and Liaison Counsel.  

September 2023

Schenectady County joined the legal action against insulin manufacturers, alleging that they artificially inflated prices for diabetes medications. The County legislature voted in favor of this decision, emphasizing its commitment to “seeking justice and reclaiming taxpayer funds.”  

August 2023

The Judicial Panel on Multidistrict Litigation (JPML) announced its decision to consolidate 13 pending insulin pricing cases into a multidistrict litigation (MDL 3080). These cases, along with any future related cases filed by government and private entities, will be transferred to the District of New Jersey, with the Honorable Brian R. Martinotti assigned to oversee them. He was already presiding over three related actions.  

July 2023

The City of Cleveland filed a complaint against insulin manufacturers and pharmacy benefit managers (PBMs), alleging that they artificially inflated insulin prices, negatively impacting self-funded health plans, their members, and beneficiaries.  

May 2023

LPR filed a lawsuit on behalf of Lake County, Illinois, claiming that drug manufacturers and PBMs created an insulin pricing scheme that benefitted the defendants by raising the prices of life-saving insulin during a diabetes epidemic. The case was filed in the U.S. District Court for the Northern District of Illinois, Eastern Division.

Choose The Alvarez Law Firm for Our Expertise in Pharmaceutical Litigation

At the Alvarez Law Firm, we have extensive experience handling pharmaceutical litigation, particularly drug pricing and consumer protection cases. We also have a history of successful outcomes in similar cases and a track record that provides confidence that we have the expertise to handle your case effectively.

Our firm has the resources necessary to take on large pharmaceutical companies and PBMs. This includes access to expert witnesses, comprehensive research capabilities, and a skilled legal team dedicated to building a strong case on your behalf. We often collaborate with other top-tier law firms and advocacy groups to strengthen our clients' cases.

More importantly, we prioritize the needs and concerns of our clients, ensuring that your voice is heard and your interests are vigorously represented. The Alvarez Law Firm often works on a contingency fee basis, meaning you pay no upfront fees and only pay if they win your case. This makes it accessible for individuals to seek justice without financial barriers.

Choosing The Alvarez Law Firm for your insulin pricing lawsuit ensures that you have a knowledgeable, dedicated, and resourceful legal team fighting for your rights. Contact us today to schedule your consultation and learn more about how we can help you.

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Frequently Asked Questions

Who are the main parties involved in these lawsuits?

What are pharmacy benefit managers (PBMs), and how are they involved?

What evidence supports the claim that insulin prices are artificially inflated?

What legal outcomes have been achieved so far?

What regulatory changes have been proposed or implemented as a result of these lawsuits?

Who are the main parties involved in these lawsuits?

The primary defendants are insulin manufacturers and PBMs. Plaintiffs typically include individuals with diabetes who require insulin, self-funded health plans, and various advocacy groups representing patients.

What are pharmacy benefit managers (PBMs), and how are they involved?

PBMs act as intermediaries between insurers, pharmacies, and drug manufacturers. The lawsuits claim that PBMs have accepted significant rebates and kickbacks from insulin manufacturers in exchange for favorably placing their products on insurance formularies, contributing to inflated prices.

What evidence supports the claim that insulin prices are artificially inflated?

Evidence presented in the lawsuits includes internal documents, testimonies, and expert analyses that suggest collusion between insulin manufacturers and PBMs. These documents allegedly show coordinated price increases and significant rebates that are not passed on to consumers.

What legal outcomes have been achieved so far?

Some lawsuits have resulted in settlements, with manufacturers and PBMs agreeing to compensate affected parties. Policy proposals and regulatory changes have also been made to increase transparency and reduce drug prices.

What regulatory changes have been proposed or implemented as a result of these lawsuits?

Regulatory changes include proposals for greater transparency in drug pricing, caps on out-of-pocket costs for insulin, and stricter oversight of rebate and pricing practices. Some states have already passed legislation to cap insulin prices and increase transparency.

Let’s talk about your case.

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