Philadelphia sues Eli Lily, CVS Caremark and others over high insulin costs

The City of Philadelphia has filed a lawsuit against several major drug manufacturers and pharmacy benefit managers, accusing them of driving up the cost of insulin.

In the lawsuit filed Tuesday, December 23, 2025, the city alleges that the companies engaged in an insulin pricing scheme that inflated the cost of diabetes medications. Named as defendants are pharmacy benefit managers CVS Caremark, Express Scripts, and OptumRx, along with drug manufacturers Eli Lilly, Novo Nordisk, and Sanofi.

According to city officials, insulin, which costs manufacturers as little as $2 to produce, has increased in price from around $20 per vial in the 1990s to between $300 to over $700 per vial today.

Through this lawsuit, the city seeks restitution, compensatory and punitive damages, and a court order prohibiting the companies from continuing what is described as unfair pricing practices.

“The City is specifically asking the Court to determine that the Defendants have violated RICO and the Pennsylvania Deceptive and Unfair Trade Practices Act,” the city wrote.

Philadelphia also claims the pricing practices forced the city to significantly overpay for insulin and other diabetes drugs while covering health benefits for more than 30,000 city employees and their dependents.

In Philadelphia, an estimated 14 percent of adults are living with diabetes, and access to medications like insulin at affordable rates is crucial.

“No one should have to worry whether they will have to go without life-saving medication due to high costs,” said Philadelphia Mayor Cherelle Parker in a news release. “As Mayor, I’m working to ensure that all residents of Philadelphia have access to what they need to live a healthy life, and we’ll continue to hold the companies that are responsible for delivering health services to the highest standard.”  

“Philadelphia suffers from one of the highest rates of diabetes in the United States, especially in our Black and brown communities. Thanks to medications like insulin, Philadelphians suffering from diabetes can live a full, healthy life,” said Department of Public Health Commissioner Palak Raval-Nelson. “Untreated, it can lead to disfigurement and death. When people cannot afford their insulin, they frequently go without or cut back, leading to disastrous consequences both for themselves and Philadelphia as a whole. Their lives are degraded, and we all pay the associated health costs.” 

NBC10 reached out to several of the companies listed in the lawsuit for comment:

An Optum Rx spokesperson provided an emailed statement reading: “This baseless action demonstrates a profound misunderstanding of how drug pricing works. For many years, Optum Rx has aggressively and successfully negotiated with drug manufacturers and taken additional actions to lower prescription insulin costs for our health plan customers and their members, who now pay an average of less than $18 per month for insulin. PBMs, like Optum Rx, are the key counterweight to pharmaceutical companies’ otherwise unchecked monopoly power to set and raise drug prices.“

Additionally, CVS Caremark gave a statement: “Pharmaceutical companies alone are responsible for the prices they set in the marketplace for the products they manufacture.  Nothing in our agreements prevents drug manufacturers from lowering the prices of their insulin products and we would welcome such an action. Allegations that we play any role in determining the prices charged by manufacturers for their products are false, and we intend to vigorously defend against this baseless suit.”

A Novo Nordisk spokesperson provided the following statement: “Novo Nordisk believes that the allegations against it are meritless, and we intend to vigorously defend against these claims. While we will not comment further about pending litigation, we recognize that not all patient situations are the same and we have a number of different insulin affordability offerings available through NovoCare^®. Importantly, we continually review and revise our offerings as well as work with diverse stakeholders to create solutions for differing patient needs. ”