ST. PAUL, Minn. (AP) — Minnesota has reached a settlement with Eli Lilly and Co. in a price gouging lawsuit against the country’s three biggest insulin manufacturers that guarantees that Minnesotans can now buy Lilly-produced insulin for only $35 a month for the next five years, Attorney General Keith Ellison announced Wednesday.

The settlement is likely to benefit as many as 500,000 residents whether they have insurance or not, and it covers all Lilly brand-name insulin products, Ellison said at a news conference. Litigation remains pending against two other manufacturers named in the 2018 lawsuit, Sanofi-Aventis and Novo Nordisk.

The American Diabetes Association says more than 8 million Americans use insulin, which the body needs to convert food into energy. People who have diabetes don’t produce enough insulin.

While Lilly and other drug manufacturers have taken steps to help diabetics cover the costs of their insulin, and Minnesota adopted an emergency safety net program for diabetics in 2020, Ellison said the settlement provides better guarantees for patients that their out-of-pocket insulin costs won’t exceed $35 a month, beginning immediately.

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“It doesn’t make sense for this lifesaving medicine to be locked behind the glass you can only break in case of an emergency, or behind a high wall of prices,” Ellison said. “This settlement shatters that glass and tears down that wall — $35 out-of-pocket, when you need it.”

New York last year reached a similar settlement with the big three insulin makers, Ellison said. And the attorneys general of California, Illinois, Arizona and Utah, and some local governments, have filed similar lawsuits in the last year, his office said. President Joe Biden’s 2022 Inflation Reduction Act capped out-of-pocket costs of insulin to people on Medicare to $35 a month, but only for seniors.

Lilly said in a statement that the settlement ensures that Minnesotans will have affordable access to its insulins, and that it builds on steps the company has already taken, including price cuts and caps announced last March, that have brought the average monthly out-of-pocket cost for Lilly insulin down to $20.48.

Novo Nordisk last year also announced plans for insulin price cuts starting this year.

Minnesota’s emergency program is named for Alec Smith, who died from diabetic complications in 2017 at the age of 26 after rationing his insulin to make it last longer.

His mother, Nicole Smith-Holt, said at the news conference that there are now multiple ways for diabetics in Minnesota to access affordable insulin, “and it’s going to save so many lives.”