FRANKFORT, Ky.– Kentucky’s attorney general has sued Express Scripts, claiming the major pharmacy benefits manager was at the center of an opioid dispensing chain that fueled a deadly addiction crisis that continues to haunt his state.
The lawsuit filed by Attorney General Russell Coleman in state court this week alleges that St. Louis-based Express Scripts and its affiliates conspired with opioid manufacturers in deceptive marketing schemes to increase sales of the addictive drugs.
The result was an epidemic of “overdoses and deaths caused by an oversupply of opioids that swept communities from powerful corporations seeking to profit at the expense of the public,” the lawsuit said.
Express Scripts responded Friday that it has long worked to combat opioid overuse and abuse and that it “will vigorously contest these baseless allegations in court.”
Government lawsuits against pharmacy benefit managers are the latest frontier — and perhaps the last big one — in years of lawsuits over the worst drug epidemic the U.S. has ever seen.
This class of drugs is linked to approximately 75,000 deaths in the US in the 12 months ending April 30. Most deaths in recent years have been linked to illicit fentanyl and other lab-produced opioids that are the drugs of choice for some users. and which are also incorporated into other illegal drugs.
Kentucky was at the epicenter of the crisis, with some of the highest overdose death rates in the country.
“Express Scripts’ role in causing the opioid epidemic has been largely hidden from the public,” the Kentucky lawsuit says. “But it has now become clear that Express Scripts has played a key role in facilitating the oversupply of opioids over the past two decades through deliberate conduct that ignored necessary safeguards to increase the prescribing, dispensing, and sale of prescription medications. opioids.”
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 control where patients go to fill their prescriptions.
For years, pharmacy benefit managers were the norm target of anger for politicians, patients and others. But PBMs have said they play an important role in controlling drug costs and pass on most of the discounts they negotiate to their customers.
In June, Arkansas has filed a lawsuit two pharmacy benefits managers, accusing them of fueling the state’s opioid crisis. The lawsuit was filed in state court against Express Scripts and Optum and their subsidiaries.
Drugmakers, wholesalers and pharmacy chains have already faced thousands of lawsuits, many of which have been settled in a series of deals that could be worth more than $50 billion over time, with most of the money to be used to combat the overdose and addiction crisis.
PBMs and several government plaintiffs are exchanging data in anticipation of a series of federal trials at least a year away. They could be a springboard for settlements.
The Kentucky lawsuit against Express Scripts and related entities says the state should receive $2,000 for each willful violation of the Kentucky Consumer Protection Act, along with any other penalties the court deems appropriate. The lawsuit was filed in Jessamine County Circuit Court in Nicholasville.
Coleman, a Republican, is the latest in a string of Kentucky attorneys general from both parties — including former attorney general and current Democratic Gov. Andy Beshear — who have gone to court to hold opioid manufacturers and distributors accountable for what they considered the interests of the companies. play a role in causing the addiction crisis.
Coleman’s predecessor, Republican Daniel Cameron, secured more than $800 million for Kentucky as part of settlements with companies over their role in the addiction crisis. Half of Kentucky’s settlements will flow directly to cities and counties. A committee oversees distribution for half the state.
The latest lawsuit alleges that Express Scripts failed to report suspicious amounts of opioids entering Kentucky. The company also dispensed opioids through mail-order pharmacies without effective controls, in violation of Kentucky and federal law, the lawsuit said.
“Express Scripts and the other pharmacy benefit managers have amassed an unprecedented level of power, using it to distribute opioid pills and conceal unlawful activity,” Coleman said in a statement Thursday. “They must be held accountable for profiting from the pain of Kentucky families. ”
Medicine overdose deaths in Kentucky fell nearly 10% in 2023, marking a second straight annual decline, but state leaders say fatalities remain tragically high and the fight against the drug epidemic is far from over. Last year, nearly 2,000 Kentuckians died from drug overdoses.
Coleman recently announced plans for one statewide drug prevention program aimed at young people. Beshear says Kentucky leads nationally in the number of residential drug and alcohol treatment beds per capita. In Washington, Senate Republican Leader Mitch McConnell has sent large amounts of federal funding to his home state to combat the addiction problem.
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Associated Press writer Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.