December 19, 2025 - Attorney General Miyares Files Lawsuit Against Pharmacy Benefit Managers and Pharmaceutical Manufacturers Over Insulin Prices

Attorney General Miyares Files Lawsuit Against Pharmacy Benefit Managers and Pharmaceutical Manufacturers Over Insulin Prices

Virginia Sues PBMs Express Scripts, CVS Caremark, OptumRx & Insulin Manufacturers Sanofi-Aventis, Novo Nordisk

RICHMOND, Va. — Attorney General Jason Miyares today filed a lawsuit against the nation’s largest pharmacy benefit managers and insulin manufacturers in the Circuit Court for the City of Richmond for violations of the Virginia Consumer Protection Act based on a years-long insulin pricing scheme that artificially inflated the price of life-saving diabetes medications and deceived consumers about those inflated prices. The lawsuit names as defendants Express Scripts, CVS Caremark, and OptumRx, as well as insulin manufacturers Sanofi-Aventis U.S. LLC and Novo Nordisk Inc. Together, these companies are enmeshed in nearly every step of insulin pricing, production, coverage, and dispensing in Virginia.

“Insulin is essential to life. For years, a group of powerful companies artificially drove up the cost of life-saving diabetes medication, enriching themselves while Virginians paid inflated prices just to survive. That system operated without transparency, deceived Virginians, and put profits over patients for far too long. This office will defend consumers from these deceptive practices,” said Attorney General Jason Miyares.

Pharmacy Benefit Managers, or PBMs, sit at the center of the prescription drug supply chain and play a powerful role in determining how much Virginians pay for diabetes medications and which drugs they can access. Virginia alleges that this outsized control, paired with a rebate system that rewarded higher list prices, created a pipeline for profit at the expense of patients.

The complaint further details how insulin manufacturers repeatedly raised list prices, often in lockstep, even as the products did not materially change and the cost to manufacture insulin declined. Virginia alleges that as list prices rose, PBMs required larger payments in exchange for preferred formulary placement. PBMs then allegedly used their position to keep prices up and competition down—all while deceiving Virginia consumers about why they were paying more.

The Commonwealth is home to hundreds of thousands of Virginians living with diabetes, many of whom rely on daily insulin injections to survive. This lawsuit follows Attorney General Miyares’ prior announcement of an investigation into PBMs and insulin manufacturers.

The Attorney General seeks injunctive relief to stop the unlawful conduct, restitution for impacted Virginia consumers, disgorgement of ill-gotten gains, civil penalties, and other relief as permitted under Virginia law.

Read the complaint here.

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