Dave Ricks

Dave Ricks became CEO of Eli Lilly in January 2017. Humalog — the company's flagship insulin — was priced at $274.70 per vial: a 1,157% increase from its 1996 launch price of $21. Manufacturing cost: approximately $2–6 per vial. Ricks held that price for six years. During those six years, Americans who could not afford insulin rationed their doses — triggering diabetic ketoacidosis, a fatal metabolic emergency. In March 2017 — Ricks' first quarter as CEO — Shane Patrick Boyle started a GoFundMe to pay for one month of insulin. He was $50 short of his goal when he died. In June 2017, Alec Raeshawn Smith, 26, was found dead in his Minneapolis apartment after rationing the insulin he could no longer afford following his aging off his parents' insurance. His monthly bill would have been $1,300. Ricks made $15.8 million that year.

• —Humalog launch price (1996): $21.23 per vial. Price in January 2017 when Ricks became CEO: $274.70. Increase: 1,157% over 20 years, more than 30 individual price increases.
• —Manufacturing cost per vial: approximately $2–6 (Senate Finance Committee investigation; Indiana AG lawsuit, 2026).
• —Shane Patrick Boyle, ~33, died March 18, 2017. GoFundMe target: $750 for one month of insulin. He was $50 short when he died from diabetic ketoacidosis. (Snopes verified.)
• —Alec Raeshawn Smith, 26, died June 27, 2017. Aged off parents' insurance. Needed $1,300/month in insulin. Found dead in his Minneapolis apartment 27 days after losing coverage. DKA cause of death.
• —T1International documented at least 4 insulin-rationing deaths in 2017, 4 in 2018, 5 in 2019 — publicly confirmed cases only; actual count is unknown.
• —1 in 4 Americans with Type 1 diabetes reported rationing insulin (T1International, 2018) — vs. 6% of Type 1 diabetics in other high-income countries.
• —An estimated 1.3 million Americans were rationing insulin at any given time (Lown Institute / peer-reviewed study).
• —The price held at $274 until March 2023, when Ricks announced a 70% cut — under direct legislative pressure from the Inflation Reduction Act and multiple congressional hearings.

A bipartisan two-year Senate Finance Committee investigation by Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) reviewed more than 100,000 pages of internal documents from Eli Lilly, Novo Nordisk, Sanofi, CVS Caremark, Express Scripts, and OptumRx. The January 2021 report found that insulin manufacturers raised prices "in tandem with competitors step for step" — not competing, but coordinating. PBMs collected escalating rebates in exchange for formulary placement, creating a system in which higher list prices benefited both manufacturers and middlemen while uninsured patients paid the list price. As of mid-2025, 416 lawsuits are consolidated in MDL No. 3080 in New Jersey federal court. Eli Lilly is a named defendant.

• —Senate Finance bipartisan report, January 14, 2021: manufacturers raised insulin prices "in tandem with competitors step for step." Not one manufacturer competing against others on price.
• —PBM contracts included "price protection" clauses allowing manufacturers to raise prices up to 12% annually — a floor, not a ceiling.
• —MDL No. 3080 (D.N.J., Judge Brian Martinotti): 416+ lawsuits pending as of 2025 from state and local governments, self-funded health plans, and individual plaintiffs.
• —Massachusetts AG complaint: manufacturers "deliberately and willingly raised prices" and paid a significant portion back to PBMs as a quid pro quo for formulary inclusion — a rebate kickback scheme.
• —FTC filed suit against CVS Caremark, Express Scripts, and OptumRx in September 2024 for a "perverse drug rebate system" that artificially inflated insulin list prices.
• —Indiana AG Todd Rokita filed suit against Eli Lilly directly in January 2026 — Lilly's home state — alleging insulin price-fixing and a coordinated scheme involving secret rebates to PBMs.
• —Minnesota AG Keith Ellison settled with Eli Lilly in February 2024, requiring $35/month insulin cap for all Minnesotans. Settlement terms effectually concede the underlying pricing claim.
• —Express Scripts settled with FTC in February 2026; Caremark and OptumRx suits continue.

In February 2019, the Senate Finance Committee launched a formal bipartisan investigation into insulin prices and called pharmaceutical executives to answer questions about pricing decisions. Sanofi CEO Olivier Brandicourt appeared. Dave Ricks did not. He sent a subordinate in his place. The investigation proceeded without Ricks' direct testimony. Roll Call reported Lilly's CEO "escaped" the hearing — as the CEO of the dominant US insulin brand, his absence was noticed. Four years later, with the IRA passed and state AG suits accumulating, Ricks did testify before the Senate HELP Committee (May 10, 2023), where he pledged not to raise insulin prices again.

• —Senate Finance Committee launched insulin price investigation, February 2019. Grassley and Wyden led the bipartisan effort.
• —Ricks declined to appear personally; Eli Lilly sent a subordinate executive.
• —Sanofi CEO Brandicourt appeared; Novo Nordisk CEO Lars Fruergaard Jørgensen also skipped.
• —Ricks did eventually testify on May 10, 2023, before the Senate HELP Committee chaired by Senator Bernie Sanders.
• —At the 2023 hearing, Ricks was the only CEO to agree outright to Sanders' demand not to raise insulin prices again. Novo Nordisk and Sanofi executives hedged.
• —By 2023, the strategic context had changed: the Inflation Reduction Act was law, the MDL had consolidated hundreds of cases, and state AGs had filed suits in multiple states.

On March 1, 2023, Eli Lilly announced it would cut Humalog's list price by 70% — from $274.70 to $66.40 per vial. Ricks presented the decision as a voluntary act. The public record offers a different sequence: the Inflation Reduction Act (2022) created Medicare drug price negotiation authority for the first time; multiple Senate hearings had put pharma CEOs on record; the Senate Finance bipartisan report had documented the lockstep pricing scheme; Minnesota, Massachusetts, and other state AGs had filed or were preparing suits; MDL 3080 was accumulating cases at pace. The price cut followed the threat of legislative and judicial accountability, not preceded it. After the cut, Humalog cost $66 — still three times its 1996 launch price and approximately 10x the manufacturing cost.

• —Humalog list price before cut: $274.70. After the 70% cut: $66.40. Manufacturing cost: ~$2–6.
• —The cut was announced March 1, 2023. It took effect gradually through 2023.
• —Inflation Reduction Act (August 2022) — signed into law eight months before the Ricks announcement — created Medicare drug price negotiation authority for high-cost drugs, with insulin a prominent case.
• —Senate Finance bipartisan investigation report published January 2021; Senate HELP Committee insulin hearings began 2023.
• —State AG suits filed or pending: Minnesota (2018, settled 2024), Massachusetts, Delaware, Arizona, Minnesota, Utah, others.
• —MDL 3080 had 85 cases at its December 2024 status conference; over 400 by mid-2025.
• —Indiana AG Rokita filed suit against Lilly specifically in January 2026 — years after the price cut — arguing the historical pricing scheme still warranted damages.
• —Eli Lilly's stock price (LLY) reached ~$900/share in 2024, driven by Mounjaro and Zepbound (GLP-1 obesity drugs); market cap near $700 billion. The insulin cut was a rounding error on revenue.

Dave Ricks' compensation has grown substantially since he became CEO. In 2024, Eli Lilly reported his total compensation at $29.2 million — a 10% raise from the prior year. For 2025, the board awarded him $36.7 million, driven by Lilly's GLP-1 drug revenue windfall. His estimated net worth as of April 2026 is approximately $620 million, primarily Eli Lilly stock. In 2017 — his first year as CEO — Shane Patrick Boyle started a GoFundMe to pay for one month of Eli Lilly insulin. He was $50 short of his $750 goal when he died from diabetic ketoacidosis. Ricks made approximately $15.8 million that year. The AFL-CIO estimates the Lilly CEO-to-median-worker pay ratio exceeded 500:1. No executive at Eli Lilly has ever been criminally charged in connection with insulin pricing.

• —Dave Ricks 2017 compensation: ~$15.8 million (year Boyle and Smith died).
• —2024 total compensation: $29.2 million (salary: $1.69M; bonus: $5.7M; stock awards: $19.75M).
• —2025 total compensation: $36.7 million (salary: $1.7M; bonus: $6.8M; stock awards: $23.3M).
• —Estimated net worth: ~$620 million (April 2026), approximately 676,970 shares of Eli Lilly stock.
• —Shane Patrick Boyle GoFundMe: $750 goal for one month of insulin. Fell $50 short. Died March 18, 2017.
• —Alec Smith: needed $1,300/month for insulin. Found dead June 27, 2017, 27 days after losing insurance coverage.
• —US average monthly cost of a vial of Humalog in 2017: $274.70. Monthly minimum wage at 40 hours/week, federal minimum ($7.25/hr): $1,257.
• —Eli Lilly's 2017 US insulin revenues: in the billions. The company reported global revenue of approximately $22.2 billion for 2023.