Delaware, Maryland along with 41 other states and Puerto Rico have filed a lawsuit against Teva Pharmaceuticals and 19 of the nation’s largest generic drug manufacturers alleging a broad conspiracy to artificially inflate and manipulate prices, reduce competition and restrain trade for more than 100 different generic drugs.

The lawsuit was filed last week by Connecticut Attorney General William Tong in the U.S. District Court for the District of Connecticut. It names 15 individual senior executive defendants. The drugs at issue account for billions of dollars of sales in the U.S. and the alleged schemes increased prices affected the health insurance market, taxpayer-funded healthcare programs like Medicaid and Medicare and individuals who must pay artificially-inflated prices for their persecution drugs.

On the lawsuit, Delaware Attorney General Kathy Jennings said “It’s hard enough for thousands of Delawareans – including many of our seniors living on fixed incomes – to afford basic health care and medication.” She continued “Schemes that tilt the playing field even further against the middle class and our must vulnerable neighbors are unconscionable, unacceptable and illegal. The people and companies responsible for this conspiracy will be held accountable.”

Maryland Attorney General said “We allege that their scheme cheated vulnerable patents, the State of Maryland and health insurance programs to the tune of billions of dollars.”

The complaint alleges that Teva, Sandoz, Mylan, Pfizer and 16 other generic drug manufactures engaged in broad, coordinated and systematic campaigns to conspire with each other to fix prices, allocate markets and rig bids for more than 100 generic drugs. These drugs span from tablets, antibiotics, capsules and creams to ointments, statins, contraceptives and anti-bionics. They treat a range of diseases and conditions including infection, diabetes, cancer, depression, multiple sclerosis, HIV and AIDs, ADHD and more. In some cases, the AG’s allege a price increase of over 1,000 percent.

The lawsuit seeks damages, civil penalties and actions by the court to restore competition to the generic drug market.

This is the second multi-state complaint the State of Delaware has joined alleging price fixing in the generic pharmaceutical market, after joining a still-pending suit in 2016 that includes 18 corporate defendants, two individual defendants and 15 generic drugs.