Pharmaceutical giant
Programs that Lilly offers to provide patient care and reimbursement support services to providers to help them prescribe Mounjaro, Zepbound, and other Lilly products violate the Texas Health Care Program Fraud Prevention Act, Texas Attorney General Ken Paxton (R) wrote in his complaint filed in Texas District Court, Harrison County.
Lilly’s practices resulted in “millions of dollars in claims to Texas Medicaid for Covered Drugs provided to Medicaid beneficiaries that were tainted by Lilly’s illegal marketing and quid pro quo arrangements, in violation of Texas Medicaid policy,” Paxton said in the complaint.
The lawsuit is Paxton’s latest attempt to rein in practices by pharmaceutical companies and pharmacy benefit managers that he says drives up costs for the state and consumers. Other Lilly drugs mentioned in the complaint include its insulin product Humalog and various injectable and orally administered cancer treatments.
“Eli Lilly fraudulently sought to maximize profits at taxpayer expense and put corporate greed over people’s health,” Paxton said in a press release, adding he “will not stand by while corporations unlawfully manipulate our healthcare system to line their own pockets.”
Texas is joined in the lawsuit by Health Choice Alliance LLC, which previously brought unsuccessful False Claims Act challenges against Lilly in the US District Court for the Eastern District of Texas. The US government successfully moved to dismiss the actions, and that dismissal was affirmed by the US Court of Appeals for the Fifth Circuit in 2021.
A Lilly spokesperson said in an emailed statement the federal government previously determined that “the relators’ allegations lack sufficient factual and legal support,” adding that “federal healthcare programs have a strong interest in ensuring that, after a physician has appropriately prescribed a medication, patients have access to basic product support relating to their medication.”
“We intend to vigorously defend against these allegations,” the spokesperson said.
Paxton filed a lawsuit last year against Lilly, other insulin makers, and the nation’s top PBMs, accusing them of working together to artificially drive up the costs of diabetes medications. That case has since been added to multidistrict litigation in the US District Court for the District of New Jersey, where more than 200 cases have been filed against insulin makers and PBMs.
The latest case is Texas v. Eli Lilly & Co., Tex. Dist. Ct., complaint filed 8/12/25.
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