Insulin is a life-saving drug. It revolutionized diabetes medications—which affect tens of millions of American insulin users and more than half a billion people worldwide—and, in an article titled “The History of a Wonderful Thing We Call Insulin,” the American Diabetes Association calls insulin a “medical marvel” responsible for improving countless patients’ quality of life over the past century.

In recent years, however, insulin prices skyrocketed. As explained in an article published in Mayo Clinic Proceedings: “The price of insulin has risen inexplicably over the past 20 years at a rate far higher than the rate of inflation. One vial of Humalog (insulin lispro), which used to cost $21 in 1999, costs $332 in 2019, reflecting a price increase of more than 1000%.” At the same time, however, “insulin prices in other developed countries, including neighboring Canada, have stayed the same.” This has led to a wave of insulin overpricing lawsuits across the United States.

“There is strong evidence to suggest that pharmaceutical companies and pharmacy benefit managers (PBMs) have been overcharging for insulin for decades. Through insulin overpricing lawsuits, patients and families are now seeking to hold these insulin manufacturers accountable.” – Dr. Nick Oberheiden, Founding Attorney of Oberheiden P.C.

Why is insulin so expensive today? The short answer appears to be the insulin pricing scheme. As the author of the Mayo Clinic Proceedings article goes on to state, “[i]nsulin pricing in the United States is the consequence of the exact opposite of a free market: extended monopoly on a lifesaving product in which prices can be increased at will, taking advantage of regulatory and legal restrictions on market entry and importation.” While the pharmaceutical companies have blamed the rising cost of research and development (among other factors) for the skyrocketing price of insulin, “[t]here is limited innovation when it comes to insulin.”

The lawsuits filed to date involve similar allegations—accusing pharmaceutical companies like Eli Lilly, Novo Nordisk, and Sanofi of engaging in unfair and deceptive trade practices in order to unjustly enrich themselves at diabetes patients’ expense. Insulin overpricing lawsuits are also targeting pharmacy benefit managers (PBMs), accusing them of conspiring with the pharmaceutical companies to charge non-competitive prices for numerous brands of insulin medications.

How Much Should Insulin Cost in the United States?

All of this raises an important question in the insulin market: How much should insulin cost in the United States? To accuse pharmaceutical companies and PBMs of overpricing insulin, it is first necessary to show how much insulin would cost if the price was dictated by ordinary market forces.

According to a study published in the journal BMJ Global Health, insulin should cost patients in the United States somewhere in the range of $48 to $71 per year. While this study came out in 2018, adjusting for inflation, this still means that the cost of insulin should only be around $60 to $88 annually. This is far less than the costs per vial of $332 in 2019, which translates to approximately $405 today. Since a vial only lasts 28 days once opened, this means that, on average, most patients are paying somewhere between $5,000 and $6,000 per year—when they should be paying less than $100.

So, clearly, insulin is vastly overpriced.

What does this mean for patients? While companies are generally free to set their prices, there are restrictions. While this is true with regard to all consumer products, it is especially true with regard to medications. When companies violate these restrictions, they can (and should) be held accountable—and this is the fundamental basis underlying the insulin overpricing lawsuits that are currently pending in courts across the country.

The (Limited) Impact of Insulin Pricing Legislation

Recognizing the skyrocketing—and, for many patients, untenable—price of insulin, legislators have started taking action. For example, in 2022 Congress enacted a law that caps the out-of-pocket cost of insulin at $35 per month for Medicare Part B and Part D enrollees.

However, the major pharmaceutical companies were heavily involved in crafting this legislation—and this is apparent from what Congress put in place. Even at $35 per month, Medicare Part B and Part D enrollees are still paying more than the data suggest they should. Additionally, this is just the out-of-pocket portion of the price of insulin—insurance companies are still paying the pharmaceutical companies as well. Let’s also not forget that Medicare Part B and Part D enrollees only make up a fraction of the patients who need insulin on a monthly basis.

Then, of course, there is the fact that millions of patients have been overpaying for insulin for decades. For many, this means that they have paid tens of thousands of dollars that they shouldn’t have had to pay. Congress’s legislation does nothing to address this issue—and the only real solution for patients who have been taken advantage of by the pharmaceutical companies and PBMs is to hold them accountable in court.

Who Can (and Should) File an Insulin Overpricing Lawsuit?

This brings us to another important question: Who can (and should) file an insulin overpricing lawsuit? Potential plaintiffs in insulin overpricing lawsuits fall into three main categories:

1. Diabetes Patients Who Have Overpaid for Insulin

The majority of plaintiffs in insulin overpricing lawsuits are diabetes patients who have overpaid for biosynthetic human insulin at some point over the past 20 or so years. In these lawsuits, diabetes patients are seeking compensation for the excessive prices they paid as well as a settlement (or verdict) that prevents the pharmaceutical companies and PBMs from overcharging for insulin in the future.

2. Parents Who Have Overpaid for Their Children’s Insulin

Parents who have overpaid for their children’s insulin are also eligible to file insulin overpricing lawsuits. While many parents struggle with the cost of their children’s medical care, parents can file claims regardless of their financial circumstances.

3. Family Members Whose Loved Ones Overpaid for (or Who Couldn’t Afford) Insulin

In some cases, family members can also file insulin overpricing lawsuits after losing their loved ones to diabetes and other medical conditions. This includes not only filing lawsuits to recover excessive insulin costs, but also filing lawsuits to hold the pharmaceutical companies and PBMs accountable for the loss of loved ones who couldn’t afford insulin.

What Can Patients and Families Expect from Insulin Overpricing Lawsuits?

What can you expect if you file an insulin overpricing lawsuit? Or, in other words, is filing an insulin overpricing lawsuit worth it?

While there are no guarantees regarding potential outcomes, the damages available in these lawsuits have the potential to be substantial. Additionally, as noted above, plaintiffs in these lawsuits are also seeking settlements or verdicts that prevent the pharmaceutical companies and PBMs from charging excessive prices for insulin in the future. As a result, pursuing an insulin overpricing lawsuit could be well worth it for many patients and families.

In the insulin overpricing lawsuits filed to date, patients and families are seeking damages including:

• Compensatory Damages for Excessive Insulin Prices – Patients who have overpaid for insulin are seeking to recover the amount that they overpaid—going back decades in many cases. Along with recovering the difference between what they paid and what they should have paid, these patients are seeking various other forms of financial compensation as well.
• Compensatory Damages for Other Losses – Some patients and family members are also seeking compensatory damages for other losses. These include damages for the loss of loved ones who were unable to afford insulin due to the artificially inflated insulin prices charged by pharmaceutical companies and PBMs.
• Punitive Damages for Willful Misconduct By Pharmaceutical Companies and PBMs – If the pharmaceutical companies and PBMs targeted in the insulin pricing litigation willfully engaged in unlawful misconduct, they may be liable for punitive damages as well. Punitive damages are intended to deter similar misconduct in the future, and they are awarded in addition to plaintiffs’ compensatory awards.

It is also important to keep in mind that hiring a lawyer to file an insulin overpricing lawsuit costs nothing out of pocket. This is because the law firms handling these cases are generally representing their clients on a contingency fee basis. This means that there is no financial risk involved in hiring a lawyer to represent you. If your insulin overpricing lawsuit is successful, your legal fees will be deducted from the amount that your lawyer helps you recover.

Given the limited effectiveness of insulin pricing legislation, insulin overpricing lawsuits are a key tool for protecting patients and their families. The more patients and family members who come forward, the more the pharmaceutical companies and PBMs will have to pay—and the more leverage plaintiffs will have to secure a favorable settlement. As we continue to learn more about what the pharmaceutical companies knew and when, the decisions they made, and how they worked together to inflate the cost of insulin in the United States, the case for compensation continues to become clearer. If you would like to know more, your next step is to schedule a free consultation.