Senators demand Cigna, Optum turn over documents on insulin prices

Chuck Grassley
Sen. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., are demanding Optum and Express Scripts turn over documents on how they determine insulin prices. Image: Gage Skidmore/CC BY-SA 2.0

Leaders of the Senate Finance Committee demanded Cigna and Optum produce critical documents over the pricing of insulin, with a subpoena threat looming.

Cigna failed to produce any documents related to the committee’s request back in April 2019 and Optum didn't produce essential documents, according to letters to both companies sent earlier this week by committee leaders. The documents would relate to the actions of pharmacy benefit managers such as Cigna’s Express Scripts on the rising costs of insulin.

“Cigna’s unwillingness to provide the documents we requested fits an industry-wide pattern of fighting efforts to shed light on PBMs’ practices,” the letter (PDF) to the insurer read.

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Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., the committee’s chairman and ranking member respectively, wrote that Cigna’s failure to comply has “reached an endpoint.” The insurer has until March 10 to provide more information or face a subpoena.

UnitedHealth Group’s Optum did produce thousands of pages for the committee, but a majority of them were irrelevant, already publicly available or duplicative.

“For example, Optum has produced more than 4,000 pages of publicly available formulary information guides and internal formulary drug lists that contain virtually no information related to the insulin therapeutic class,” the senators’ letter (PDF) to Optum said.

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The original request for documentation had called for internal communications that would help the committee understand how Optum made decisions on “the out-of-pocket price patients pay for their insulin,” the letter said.

Grassley and Wyden launched the investigation last February into the price of insulin, which has increased up to 500%. The senators sent letters to leading insulin manufacturers Eli Lilly, Novo Nordisk and Sanofi regarding the spike.

The senators also wanted to learn the process used for negotiations and agreements between PBMs and large plans on patient cost-sharing.

Cigna-Express Scripts said that it takes the committee's inquiry "very seriously and have been engaged with them on this request. We are committed to being cooperative."

Optum said that it share's the committee's concens regarding the high prices for insulin set by manufacturers. 

"We have provided thousands of pages of documents in response to the committee's request, and will continue to work with them on this important issue," the company said.