More than 40 drug companies and pharmacy benefit managers submitted reports to the state detailing the costs associated with manufacturing and selling essential diabetes drugs by this month’s deadline, though almost as many have yet to report, information obtained by The Nevada Independent shows.

The nation’s largest insulin manufacturers, Sanofi-Aventis, Novo Nordisk, and Eli Lilly, have all submitted the required reports to the state, as have 28 other drug companies, including four that weren’t required to submit reports but did so out of an abundance of caution, according to the state. CVS Health, Express Scripts and OptumRx — the country’s three largest pharmacy benefit managers (PBMs), which act as the go-between for drug manufacturers, insurers and pharmacies — are among the 11 PBMs that submitted reports.

The Independent obtained the lists of companies from the state through a public records request.

Drug companies and PBMs are required to submit annual reports to the state explaining the costs associated with essential diabetes drugs and, for some, why the costs of those drugs increased significantly over the prior year in accordance with a new law created during the 2017 legislative session. In June, the state extended the deadline from July 1, 2018 to Jan. 15, 2019 to give companies additional time to prepare their first reports.

Still, 23 drug companies identified as manufacturers of essential diabetes drugs have yet to report to the state. Scott Jones, manager of the Primary Care and Health Workforce Development Office, said in an email that the state will be reaching out to those companies to inform them of the law and obtain the required reports. (If they refuse, the state is allowed by law to impose a fine of $5,000 a day.)

He said that the state is also working to identify additional pharmacy benefit managers who may have been required to report but have not yet. However, he added that the state has completed an initial analysis and not yet identified any additional pharmacy benefit managers required to comply with the law.

“We will continue our analysis and add additional PBMs as we identify them,” Jones said.

The state will review the information in the reports and produce an aggregated report explaining the factors contributing to the costs of drugs used to treat diabetes. Julie Kotchevar, administrator of the Department of Public and Behavioral Health, said earlier this month that the state hopes to complete the report by February.

Elements of the individual reports — including profits manufacturers earned from the drugs and rebates that PBMs negotiated and kept on the drugs — may be kept confidential under a regulation approved by the state last summer. However, other elements not marked confidential may be subject to disclosure under the state’s public records law. The Independent has filed a public records request for that information.

See which companies have complied with the reporting requirements below.

Update 1/25/19 at 1:27 p.m.: This article has been updated to reflect information mistakenly given by the state, removing Takeda Pharmaceuticals, Inc. from the list of companies required to report and updating Takeda Pharmaceuticals America, Inc., a subsidiary, to Takeda Pharmaceuticals USA, Inc.

Update 1/28/19 at 9:20 a.m.: This article has been updated to reflect that reports for three companies — Greenstone, Pharmacia & Upjohn and Mylan Institutional — were included in an affiliated company's report. The state previously believed those companies had not yet reported.