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Oregon Sues Insulin Giants for $900 Million Over Alleged Price Scheme as Many Patients Still Face High Costs News By Diane Megaw On Jan 8, 2026 Last updated Jan 8, 2026 Photo by i-SENS, USA As part of a broader effort to lower prescription drug costs and address harms to working families, Oregon Attorney General Dan Rayfield filed a lawsuit yesterday targeting a scheme that allegedly costs Oregon patients hundreds of millions of dollars. Oregon Lawsuit To Claw Back $900 Million Over High Insulin Prices In a lawsuit in the Multnomah County Circuit Court against the nation’s largest insulin manufacturers and pharmacy benefit managers (PBMs), the Oregon DOJ is seeking $900 million in damages. Tidings Data Snapshot Oregon Diabetes Burden / $900M Insulin Lawsuit $900M+ Damages Oregon DOJ says it will seek 6 Companies named: 3 manufacturers / 3 PBMs 354,400 Oregon adults with diagnosed diabetes 24,000 Estimated adults diagnosed each year in Oregon $5.3B Estimated annual cost of diagnosed diabetes in Oregon Source: Oregon DOJ media release (Jan 7, 2026) / American Diabetes Association “The Burden of Diabetes in Oregon” (Feb 2025) Dailytidings.com The DOJ says they worked together in a coordinated scheme to artificially inflate the price of insulin and other critical diabetes medications at the direct expense of Oregon patients and families. AG Rayfield said: “This is about more than insulin prices – it’s about the crushing cost pressures families are facing and the very real harm that comes when corporations exploit people who have no choice but to pay.” The defendants are insulin manufacturers Novo Nordisk, Sanofi, and Eli Lilly, with pharmacy benefit managers Express Scripts, CVS Caremark, and Optum. These companies dominate the insulin and prescription drug markets, controlling which medications are available to patients, at what price, and under what conditions. The lawsuit alleges that the companies worked in concert to ensure an enormous boost in insulin prices. Manufacturers allegedly raised list prices, then paid substantial rebates and fees to PBMs to secure favorable placement on PBM formularies. It also alleges that PBMs and manufacturers intentionally excluded lower-cost insulin options from formularies, denying patients access to more affordable treatments and locking in inflated prices across the market. These practices have taken a severe toll on Oregonians- particularly uninsured and low-income patients who were forced to ration medication, use expired insulin, reuse needles, or skip meals to control blood sugar levels, putting their health and lives at risk. The lawsuit is the first of a broader enforcement push by the ODOJ to confront unlawful prescription drug pricing practices and reduce costs for consumers, and argues that the companies violated Oregon’s Unlawful Trade Practices Act. The AG is seeking a court order to stop the alleged scheme, restitution for consumers, disgorgement of ill-gotten profits, and damages estimated to exceed $900 million. Oregon Caps Insulin On State-Regulated Plans Oregon recently capped out-of-pocket costs for insulin under state-regulated health plans; for example, the cap under SB 1508 is $35 per 30-day supply or $105 for a 90-day supply, but these state laws apply to state-regulated health plans. Here is the quick cheat sheet on who actually gets a $35 insulin cap. Coverage type Insulin out-of-pocket cap What this means Oregon state-regulated health benefit plans $35 per 30 day supply / $105 per 90 day supply Applies to covered insulin under Oregon’s cap for health benefit plans offered in the state Medicare Part D $35 per month per covered insulin product No deductible for insulin / a 3 month fill generally totals $105 Medicare Part B (insulin pump covered as DME) $35 per month per covered insulin product Applies when Part B covers the insulin tied to a covered pump Self-insured employer plans No automatic Oregon cap Cost depends on the employer plan’s pharmacy benefit design Those with self-insured employer plans are outside state insurance rules, and insulin affordability still depends on prices upstream. For insulin coverage under private health insurance and Medicare, Congress has capped insulin costs at $35 for all Medicare beneficiaries, but similar price cap legislation for people with private health insurance has been blocked in the Senate. Share Twitter Facebook ReddIt WhatsApp Pinterest Email