Hamilton County has filed a lawsuit against major pharmacy benefit managers (PBMs) CVS Caremark, Express Scripts, and OptumRx, along with drug manufacturers Eli Lilly, Novo Nordisk, and Sanofi, alleging they unlawfully inflated the price of insulin and other diabetes medications for years.

The county claims it paid excessively high prices for insulin for its employees and dependents due to an illegal pricing scheme between manufacturers and PBMs. The lawsuit seeks financial compensation for taxpayers and health plan members and a court order to stop the alleged practices.

The suit was filed by the Hamilton County Board of Commissioners with County Prosecutor Connie Pillich.

“Some healthcare companies are prioritizing profits over patients,” Pillich said. “Our goal is to protect taxpayers and hold those responsible accountable.”

The Board of Hamilton County Commissioners is concerned about citizens.

Commission President Stephanie Summerow Dumas: “Insulin is a lifesaving medication that has been around for decades, yet families and employers are paying more than ever to access it. When drug companies and middlemen drive up costs, it hurts our employees, their families, and ultimately taxpayers. That’s why Hamilton County is taking action so we can demand fairness and accountability without putting taxpayers at financial risk, and push for a system that puts people first.”

Commission Vice President Alicia Reece: “When Hamilton County is forced to overpay for prescription drugs, that is taxpayer money that could be going toward road repairs, first responders, or educational opportunities. From 2023 to 2025 alone, diabetes medications were the single highest cost prescription drug category in our county health plan -- nearly $13 million for about 8,800 Hamilton County employees and covered family members. The healthcare system should protect our community, not drain resources from it, and we are taking action to ensure fair prices for lifesaving medications.”

Commissioner Denise Driehaus: “A handful of corporations control most of the insulin market, and families are paying the price. Hamilton County is standing up to hold them accountable and make sure lifesaving medicine is affordable for the people who need it.”

Hamilton County provides health coverage to about 8,800 plan members. From 2023 to 2025, insulin-related costs totaled nearly $13 million. 

The federal lawsuit is similar to other litigation across the nation alleging PBMs and manufacturers coordinated to artificially raise insulin prices across the country. The firms representing Hamilton County are working on a contingent basis, meaning there's no financial risk to county taxpayers from this litigation.

The PBMs named in the lawsuit together control 96 percent of the global market for insulin.