Eli Lilly agrees to $13.5M settlement in insulin lawsuit, agrees to $35 price cap

Eli Lilly is one of the country’s oldest drug manufacturers, notable for introducing the world to Prozac. This year, it was one of the pharmaceutical companies caught up in Congress’s investigation into the high price of insulin, but that didn’t seem to have dampened the company’s market performance.

Drugmaker Eli Lilly has reached a settlement with insulin buyers following six years of litigation. The company agreed to pay a $13.5 million settlement and continue its cap on users’ out-of-pocket costs for four years.

Under the settlement, insulin users unable to qualify for the $35-a-month cap — people who no longer use Eli Lilly insulin or those now enrolled in the Medicare and Medicaid programs — may tap into the $13.5 million fund, which also is being used to pay administration costs and fees for the plaintiffs’ attorneys.

“This settlement will bring immense, forward-looking relief, especially for those who are underinsured or paying with co-insurance – those most in need of assistance paying for the medications they need to live,” said Steve Berman, managing partner and cofounder of Hagens Berman and court-appointed co-lead counsel representing insulin purchasers in the lawsuit. “Those paying out of pocket for insulin will receive four years of insulin at a reduced price under the settlement. Our experts calculate this will save these consumers $500 million in payments for their insulin over the four-year period.”

A 2022 study in the Annals of Internal Medicine estimated that 1.3 million Americans ration their insulin because of the cost. Attorneys for the buyers said some users gave accounts of resorting to extreme measures to afford insulin, including starving themselves to control their blood sugar levels and intentionally slipping into ketoacidosis, a serious complication of diabetes, to receive insulin from hospital emergency rooms.

“The settlement contains no admission of liability or wrongdoing by Lilly,” a company spokesperson said, adding that “the agreement is a reflection of our continued commitment to close gaps in the U.S. health-care system for people with diabetes.”

Related: Eli Lilly caps the cost of insulin at $35 a month, following California lawsuit

The class covered by the lawsuit includes “anyone in the U.S. who paid any portion of the purchase price for any Lilly insulin product, for themselves or on behalf of any family member or dependent” from Jan. 1, 2009, up to the final approval order for the settlement. Under the agreement, eligible insulin buyers would be able to obtain and file claims forms on the settlement website.

The settlement still must be approved by the U.S. District Court for the District of New Jersey. Upon preliminary approval of the settlement, attorneys for the plaintiffs plan to subpoena the six largest pharmacy benefit managers and the seven largest retail pharmacy chains in the United States to gather transactional data that will be used to verify settlement claims.