Bucks County Sues Over Insulin Prices
Claiming that the cost of insulin has increased some 1,000 percent over the last 20 years, Bucks County officials are joining an ongoing federal lawsuit against insulin manufacturers and pharmacy benefit managers (PBMs).
At a press conference last week, Bucks County Solicitor Amy Fitzpatrick said the manufacturers and PBMs are rigging prices in “an illegal price-fixing scheme.” That makes it much more expensive for the county, which is self-insured, and for the people who are part of its health plan.
She mentioned that PBM defendants CVS Caremark, Express Scripts and Optum RX control “80 percent of the market managing pharmacy benefits,” and manufacturers Eli Lilly, Novo Nordisk, and Sanofi “control 95 percent of the global diabetes drug market.”
They raise prices “in lockstep, “which is not how a “fair, competitive market works,” she said. Insulin, which was developed 100 years ago, costs about $2 per vial to make. But patients are paying hundreds, she said.
District Attorney Jennifer Schorn has filed a companion lawsuit using the state’s consumer protection law.
“Anyone who lives with this disease or the loved ones of those who live with this disease know the impact of this price-fixing scheme,” said Schorn.
Commissioner Diane Ellis-Marseglia said the county has been overcharged for insulin by millions.
“It makes no sense,” she said.
Commissioners Chairman Bob Harvie said his daughter was diagnosed with Type 1 diabetes when she was 14 and depends on insulin to live.
“She is now a healthcare professional herself. But she remains and will always remain a Type 1 diabetic, relying on insulin and dependent on that medication every day to keep her alive,” said Harvie.
The question is how many actual patients are paying the prices for insulin mentioned by Bucks County officials.
For example, the Inflation Reduction Act, which President Joe Biden signed in 2022, caps out-of-pocket insulin costs at $35 a month for Medicare enrollees. In response, three drug manufacturers reduced the price of insulin to $35 through price caps or savings programs.
According to Politifact, the estimated out-of-pocket insulin cost for people with diabetes enrolled in Medicare or private insurance is around $452 a year, or about $38 per month.
The suit is one of many the commissioners have filed “over the last five years since this administration came into office,” Harvie said.
They include suits against manufacturers over PFAS chemicals in water, social media companies, and petroleum manufacturers, he said, without mentioning that a judge just dismissed the case against energy companies with prejudice. The county has also sued big food companies over obesity.
The county used “the power of this office to fight for our residents, to protect them when we saw unfairness,” Harvie said.
On Friday, a judge threw out the Bucks County Democrats’ lawsuit against energy companies “with prejudice,” declaring it unconstitutional.
Harvie called the price of insulin “corporate greed at its worst.”
“Insulin in the United States costs five times what it does in Chile, six times what it does in Mexico, eight times what it does in Canada, 10 times what it does in Italy, the Netherlands, or Ireland, 13 times what it does in Sweden or the U.K., 18 times what it does in Poland,” he said.
“Our residents and people across this country shouldn’t have to choose between affording diabetes medication and putting food on the table,” said Harvie. “This county will not stand idly by while Big Pharma abuses its power, to negatively impact our tax base or the health plans we offer here.”
Dr. Marion Mass, a pediatrician and a board member of Free2care, who has researched and written about PBMs, questioned the county’s decision to sue.
“Who is responsible for choosing the PBM that the Bucks County government is contracting with?” asked Mass. “It seems to me that if Bucks County’s chosen PBM is costing Bucks County employees and taxpayers more, someone made a poor choice. The county is suing a company that they chose.”
In the Democratic push to pass the IRA, former Sen. Bob Casey Jr. (D-Pa.) claimed that the law would cap insulin at $35 a month. The IRA also gave PBMs “a free pass” to ignore price-fixing laws that govern other industries, Mass wrote.
The IRA was “a big gift to the PBMs,” Mass told DVJournal.
“It’s completely legal for the pharmaceutical companies and the PBMs to get together and negotiate,” added Mass, noting the arrangement dates to the President George W. Bush administration. “It’s because the PBMs have an exemption to the anti-kickback statute.”
