FRANKFORT, Ky. (AP) – Kentucky’s attorney general has expanded an opioid-related lawsuit to target another major pharmacy benefit manager he says contributed to the state’s deadly addiction crisis.
OptumRx has been added as a new defendant in the lawsuit filed two months ago, Attorney General Russell Coleman said Tuesday. His claims against Optum and its affiliated organizations are similar to those initially filed against Express Scripts, which remains a defendant in the case.
The Republican attorney general accused Optum of playing a central role in what he called the reckless promotion, dispensing and oversupply of opioids. OptumRx operates a pharmacy network consisting of approximately 67,000 pharmacy locations nationwide, the lawsuit said.
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Kentucky was ravaged by the addiction crisis, resulting in some of the highest overdose death rates in the country.
“These groups pushed a profit-driven agenda at the expense of Kentucky families who were left with empty seats at the dinner table,” Coleman said in a news release.
Optum did not immediately respond to emails seeking comment on Tuesday. When sued in September, Express Scripts responded that it has a long history of working to combat opioid overuse and abuse and that it would “vigorously contest these baseless allegations in court.”
Coleman initially filed the legal action in state court, but the two sides are arguing over whether to do so in state or federal court, his office said. He wants the case to be heard in state court.
Coleman has accused the defendants of using deceptive marketing to boost sales of highly addictive drugs. They also dispensed opioids through mail-order pharmacies without effective controls, in violation of Kentucky and federal law, he said.
He seeks, among other things, civil penalties for any willful violation of the Kentucky Consumer Protection Act, plus any other damages the court deems appropriate.
“Defendants have concealed their conduct through non-transparent business practices and by requiring any entity with which they do business, such as opioid manufacturers, to enter into confidentiality agreements or otherwise keep their agreements confidential,” the lawsuit said.
Pharmacy benefit managers, or PBMs, manage prescription drug coverage for health insurers and employers that provide coverage. They help decide which medications make up a plan’s formulary, or list of covered medications. They can also determine where patients go to fill their prescriptions.
PPE has drawn the ire of politicians, patients and others for years. PBMs say they play an important role in controlling drug costs and pass on most of the discounts they negotiate to their customers.
Government lawsuits against pharmacy benefit managers are the latest frontier – and perhaps the last big one – in years of litigation over the opioid-related drug epidemic in the US.
Drug manufacturers, wholesalers and pharmacy chains have already faced piles of lawsuits and settled many of them, with most of the money directed to be used to combat the overdose and addiction crisis.
The overdose death rate began rising steadily in the 1990s due to opioid painkillers, followed by waves of deaths led by other opioids such as heroin and — more recently — illicit fentanyl. The decline in drug overdose deaths in the US appears to have continued this year, giving experts hope that the country sees lasting improvement in the ongoing epidemic.
Drug overdose deaths in Kentucky fell by nearly 10% in 2023, marking a second straight annual decline. But state leaders say deaths remain tragically high and the fight against the drug epidemic is far from over. Last year, nearly 2,000 Kentuckians died from drug overdoses.
