Sprouts Farmers Market is the latest major company to file a lawsuit against major pharmacy benefit managers and insulin manufacturers.
The lawsuit alleges that PBMs CVS’ Caremark, Cigna’s Express Scripts and UnitedHealth’s OptumRx, the three largest pharmacy benefit managers in the U.S., conspired with insulin manufacturers Eli Lilly, Novo Nordisk and Sanofi, who manufacture nearly all of the insulin and other diabetes medications available in the U.S., to profit from artificially inflated insulin prices.
Sprouts employs 11,000 workers, a press release said, noting that the company spends millions each year on insulin medications.
“[T]hese middlemen [PBMs] capture as much as half of the money spent on each insulin prescription… even though they contribute nothing to innovation, development, manufacture, or production of the drugs,” according to the complaint, which was filed on Friday.
Sprouts is now seeking to “recover for the losses it has suffered” due to the insulin manufacturers and PBMs’ “illegal Insulin Pricing Scheme,” per the complaint.
The lawsuit claims the three insulin manufacturers published prices for diabetes medications throughout Arizona, where Sprouts is based, with the “express knowledge that payment and reimbursement by [Sprouts] would be based on those false list prices,” according to the complaint. Sprouts then purchased these drugs based on “false list prices generated by the Insulin Pricing Scheme” through employee health plans.
From there, PBMs continued to give “rise to the Insulin Pricing Scheme,” damaging payors, including Sprouts, the complaint said.
In September 2024, the Federal Trade Commission filed a suit against Caremark, Express Scripts and Optum Rx for directing patients toward higher-priced insulin to allegedly bring in larger rebates from pharmaceutical manufacturers, sister publication Healthcare Dive reported.
The FTC said the companies have “abused their economic power by rigging pharmaceutical supply chain competition in their favor, forcing patients to pay more for life-saving medication.” Express Scripts, Caremark and Optum Rx have denounced the FTC lawsuit, with Caremark saying the suit is based on a “profound misunderstanding of how drug pricing works,” a spokesperson told Healthcare Dive last year.
