Lawsuit Targets Scheme Allegedly Costing Oregon Patients Hundreds of Millions of Dollars; Part of Broader Effort to Lower Prescription Drug Costs and Address Harms to Working Families

Attorney General Dan Rayfield filed a major lawsuit seeking $900 million dollars in damages today against the nation’s largest insulin manufacturers and pharmacy benefit managers (PBMs), alleging 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.

“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,” said Attorney General Rayfield. “When companies jack up the price of life-saving drugs, they don’t just impact wallets, they exacerbate stress, anxiety and mental health crises for people who are already struggling to make ends meet.”

The lawsuit, filed in Multnomah County Circuit Court, names three insulin manufacturers—Novo Nordisk, Sanofi, and Eli Lilly—and three pharmacy benefit managers—Express Scripts, CVS Caremark, and Optum. Together, these companies dominate the insulin and prescription drug markets, controlling which medications are available to patients, at what price, and under what conditions.

According to the complaint, the manufacturers and PBMs allegedly worked in concert to ensure an enormous boost in insulin prices. To secure favorable placement on PBM formularies, manufacturers allegedly raised list prices and then paid substantial rebates and fees back to PBMs. The higher the list price, the larger the rebate—and the greater the profit for both sides.

The lawsuit further 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.

The complaint details the severe toll this alleged conduct has taken on Oregonians—particularly uninsured and low-income patients. As insulin prices soared, patients 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 marks the first major announcement this year in a broader enforcement push by the Oregon Department of Justice to confront unlawful prescription drug pricing practices and reduce costs for consumers. Attorney General Rayfield is actively examining the role of PBMs and other entities in the prescription drug supply chain and continues to investigate additional companies and practices that may be contributing to inflated drug prices. ODOJ also announced settlements involving inflated drug prices last year.

“We are working to bring the cost of prescription drugs down for working families, using the tools we have to hold these powerful companies accountable. Oregonians can expect more action in the near future,” said Attorney General Rayfield.

The lawsuit alleges violations of Oregon’s Unlawful Trade Practices Act, including misleading conduct and unconscionable practices that exploited a highly vulnerable population. The Attorney General seeks a court order to halt the alleged scheme, restitution for consumers, disgorgement of ill-gotten profits, and damages estimated to exceed $900 million.