Sanofi, Lilly, Novo and trio of PBMs face racketeering charges over insulin drug pricing

Jul 13, 2022. Diabetes giants Sanofi, Eli Lilly and Novo Nordisk, plus a trio of pharmacy benefit managers will have to face racketeering charges over claims they systematically hiked the price of insulin drugs.

U.S. District Judge Brian Martinotti on Friday denied motions by the defendants—which also include PBM bigwigs OptumRx, Caremark and Express Scripts—to scrap claims under the Racketeer Influenced and Corrupt Organizations (RICO) Act.

Martinotti did drop antitrust claims under the Robinson-Patman Act, meant to stop distributors from charging different prices to retailers, and the Sherman Antitrust Act, which more broadly targets monopolies.

“Sanofi is pleased that the court has narrowed the claims at issue,” a spokesperson said over email, adding that the ongoing charges are also “without merit.”

Novo Nordisk is also pleased that the Court dismissed all of the antitrust claims, “and we will continue to defend the company against the remaining claims,” a spokesperson told Fierce Pharma, citing the company’s “longstanding commitment to supporting patients’ access to [its] medicines.”

The RICO claims stand for now, given the plantiff’s compelling case that the drugmakers may have engaged in bribery, plus mail and wire fraud, Martinotti said in the court filing.

Both companies said they can’t speak further on ongoing litigation. Eli Lilly did not immediately respond to Fierce Pharma’s request for comment.

Last year, drug wholesalers filed a lawsuit accusing Novo, Lilly and Sanofi of boosting prices of their insulin analog drugs through rebates with PBMs, in turn securing favorable placement on those benefit managers’ prescribing lists, the court filing states.

Analog insulin, which is a subgroup of insulin drugs, is typically preferred for diabetes treatment because it “more closely [mimics] the way the human body naturally absorbs insulin released by the pancreas,” the plaintiffs are quoted as saying in the court filing. Novo makes several insulin analogs, including NovoLog and Levemir, while Eli Lilly markets Humalog and Sanofi sells Lantus and its follow-up, Toujeo.

The New Jersey judge tossed out the antitrust claims on the grounds that the wholesalers who sued aren’t in direct competition with Sanofi, Novo and Lilly, nor are they insurers that hire the PBMs who allegedly received rebates from the drugmakers. The drugmakers also did not collude directly to set prices, he said.

The judge agreed that the plaintiffs failed “to plead ‘parallel conduct’ suggestive of a conspiracy.” In an amended complaint, the plaintiffs claim the trio of drugmakers were made to “compete for—rather than conspire together to maintain—the respective prices of their analog insulins,” the court filing states.

The lawsuit is separate but similar to another case leveled by consumers against Novo, Lilly and Sanofi alleging the drugmakers engaged in an “arms race” to inflate list prices of their insulin drugs. (