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Hiya, and welcome back to The Readout. 

Today, we’re getting ready for the FDA’s upcoming decision on Moderna’s mRNA flu shot, and see both a revived fight over 340B rebates and fresh legal scrutiny for Lilly’s insulin pricing.

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Sandoz agreed to pay $478.5 million to settle allegations by dozens of states and resellers of medicines that the company engaged in a widespread conspiracy to artificially inflate and manipulate prices of generic drugs and harmed consumers by reducing competition.

Under one settlement, the company agreed to pay $400 million over seven years starting in 2027 to resolve all remaining claims by U.S. states in three pending cases and make an additional payment of about $50 million to states that settled earlier. Another $28.5 million will be paid to resolve all remaining class-action litigation brought by indirect resellers. Sandoz did not admit to any wrongdoing.

The agreement marks the latest settlement in a long-running battle between numerous states and many of the largest players in the generic drug industry, which were accused of fixing prices for their medicines. Previously, Glenmark Pharmaceuticals, Lannett, Bausch, Apotex, and Heritage Pharmaceuticals collectively settled lawsuits for nearly $98 million.

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Novo Nordisk was banking on the inflammatory benefits of its investigational therapy ziltivekimab to improve cardiovascular outcomes. Last week’s Phase 3 failure dashed not just the Danish pharma’s hopes but that of other drugmakers working on the same pathway.