Pharmacy Benefit Managers Sued in Arkansas Over Opioid Crisis

Arkansas last Monday filed a lawsuit against the pharmacy benefit managers Optum, Inc. and Express Scripts, Inc. over their alleged role in fueling the opioid epidemic in the state.

Pharmacy benefit managers (or PBMs) oversee prescription coverage for large clients such as insurance companies and employers. PBMs determine which medications are covered under insurance plans and decide which pharmacies patients can use to fill prescriptions.

The lawsuit, filed in state court by Arkansas Attorney General Tim Griffin, alleges that Optum, Express Scripts, and their subsidiaries benefited from the opioid epidemic “by negotiating favorable deals” with the manufacturers and by failing to take “sufficient action to curb excessive opioid prescriptions.”

The attorney general accuses the PBMs of taking a “central role” in the oversupply of the drugs for at least twenty years and alleges that they “ignored the necessary safeguards” to boost opioid prescriptions and sales.

Optum, Inc. denied the allegations, saying in a statement last week that it did not cause or worsen the opioid epidemic and would defend itself against the lawsuit.

The company said that it takes the epidemic “seriously” and has “taken a comprehensive approach” to fighting the opioid crisis by implementing an Opioid Risk Management Program for all of its clients.

The lawsuit notes that by 2016, Arkansas had the second-highest prescribing rate of opioids in the United States, with more than 114 doses prescribed for every 100 people in the state. The national average is just 78 doses per 100 people.

Attorney General Griffin said in a June 24 statement that Optum and Express Scripts “focused on the financial incentives of manufacturer rebates to drive up profits at the expense of the people.”

Opioid overdoses have been linked to roughly 80,000 drug deaths each year in the United States. The majority of overdose deaths in recent years have been caused by fentanyl and other synthetic opioids illegally produced and often found in other illicit substances.