Arkansas on Monday sued two pharmacy benefit managers (PBMs) that oversee coverage for insurers, employers, and other large clients, accusing them of fueling the opioid crisis in the state.
Attorney General Tim Griffin (R) filed the lawsuit against Express Scripts, Optum, and their subsidiaries, in state court.
PBMs run prescription drug coverage for big clients that include health insurers and employers that provide coverage. They help decide which drugs make a plan's formulary, or list of covered medications. They also can determine where patients go to fill their prescriptions.
Griffin's lawsuit said the companies benefited from the opioid crisis "by negotiating favorable deals with opioid manufacturers and by not taking sufficient action to curb excessive opioid prescriptions."
"For at least the last two decades, defendants had a central role in facilitating the oversupply of opioids," the lawsuit said. "Defendants ignored the necessary safeguards in order to ensure increased opioid prescriptions and sales."
In a statement, Optum said it has taken steps to fight the opioid epidemic and would defend itself against Arkansas' suit.
"Optum did not cause the opioid crisis or make it worse, and we will defend ourselves in this litigation," the company said in a statement. "Optum takes the opioid epidemic seriously and has taken a comprehensive approach to fight this issue, including the Opioid Risk Management Program available to all Optum Rx clients, to address opioid abuse and promote patient health."
Express Scripts did not immediately respond to a request for comment.
According to the lawsuit, opioids were the most commonly prescribed class of controlled substances in Arkansas in 2022, and Arkansas had the second-highest opioid prescribing rate in the nation that year.
State and local governments have filed thousands of lawsuits over the toll of the opioid crisis. The claims have included asserting that drugmakers, wholesalers, pharmacy chains, and other businesses engaged in deceptive marketing and failed to stop the flow of the powerful prescription painkillers to the black market.
Many of the major cases have been settled, with proposed and finalized agreements to provide more than $50 billion -- with most of it to be used . A federal judge who is overseeing federal lawsuits over opioids is lining up cases involving PBMs for trials, possibly a precursor to settlements.
In recent years, opioid overdoses have been linked to about 80,000 deaths annually in the U.S. The majority of those lately have involved fentanyl and other potent drugs produced illicitly in labs and often used to lace other illegal drugs.