By Jonathan L. Swichar, Bradley A. Wasser, Sean P. McConnell, Christopher H. Casey and Patrick Gavin
On October 9, 2026, the Pennsylvania Attorney General’s Office sued the country’s three largest pharmacy benefit managers and three largest insulin manufacturers, alleging that they participated in an alleged insulin-pricing scheme. According to the complaint, the manufacturers raised list prices for their diabetes drugs and secretly paid rebates and fees to the PBMs in exchange for preferred formulary placement of those drugs, while the PBMs excluded lower-priced alternatives and profited from the inflated prices. The Pennsylvania attorney general’s lawsuit is significant because Pennsylvania—unlike all other states—has no general antitrust statute. The complaint alleges that the defendants’ conduct violates Pennsylvania’s consumer protection statute, the Unfair Trade Practices and Consumer Protection Law.