FRANKFORT, Ky. (AP) — Kentucky’s attorney general has sued Express Scripts, alleging the major pharmacy benefit manager was at the center of an opioid dispensing chain that fueled a deadly addiction crisis that continues to plague his state.
The lawsuit, filed this week in state court by Attorney General Russell Coleman, alleges that St. Louis-based Express Scripts and its affiliates colluded with opioid manufacturers in misleading marketing schemes to raise sales of the addictive drugs.
The result was an epidemic of “overdoses and deaths caused by an oversupply of opioids that flooded communities from powerful corporations seeking to profit at the expense of the public,” the lawsuit says.
Express Scripts responded Friday that it has long worked to combat opioid overuse and abuse and will “vigorously contest these baseless allegations in court.”
State lawsuits against pharmacy benefit managers are the latest — and perhaps last major — frontier in years-long legal battles over the worst drug epidemic the U.S. has ever seen.
This class of drugs is linked to about 75,000 deaths in the 12 months ended April 30 in the United States. Most deaths in recent years have been linked to illicit fentanyl and other lab-made opioids, which are the drugs of choice for some users and which are also found in other illicit drugs.
Kentucky was at the epicenter of the crisis and had the highest overdose death rate in the nation.
“Express Scripts’ role in creating the opioid epidemic has been largely hidden from the public,” the Kentucky lawsuit says. “However, it has now become clear that for no less than the past two decades, Express Scripts has played a key role in driving the oversupply of opioids through deliberate conduct that disregarded necessary safety precautions to facilitate the prescribing, dispensing and sale of prescriptions “Opioids.”
Pharmacy benefit managers (PBMs) handle prescription drug coverage for health insurers and employers that offer coverage. They support decide which medications to include in a plan’s formulary or list of covered medications. You can also control where patients go to fill their prescriptions.
For years, pharmacy benefit managers have been the target of ire from politicians, patients and others. However, PBMs have said they play an vital role in controlling drug costs and pass on most of the discounts they negotiate to their customers.
In June, Arkansas sued two pharmacy benefit 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 and settled many of them in a series of deals that could be worth more than $50 billion over time, with most of the money going to fightback the overdose and addiction crisis would need to be used.
PBMs and several state plaintiffs are exchanging documents in anticipation of a series of federal lawsuits that will last at least a year. They could be a springboard for settlements.
Kentucky’s lawsuit against Express Scripts and its affiliates states that 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 attorneys general from both parties in Kentucky — including former attorney general and current Democratic Gov. Andy Beshear — to go to court to hold opioid manufacturers and distributors accountable for what they see as the companies looked at. role in the emergence of the addiction crisis.
Coleman’s predecessor, Republican Daniel Cameron, pledged more than $800 million to Kentucky in settlements with companies over their role in the addiction crisis. Half of Kentucky’s housing will go directly to cities and counties. A commission monitors the distribution of half of the state.
The latest lawsuit alleges Express Scripts failed to report suspicious amounts of opioids flowing into Kentucky. The company also dispensed opioids through mail-order pharmacies without effective controls, violating Kentucky and federal laws, the lawsuit says.
“Express Scripts and the other pharmacy benefit managers have amassed an unprecedented level of power by using it to distribute opioid pills and conceal unlawful activities,” Coleman said in a statement Thursday. “They must be held accountable for profiting from the suffering of Kentucky families.”
Drug overdose deaths fell nearly 10% in Kentucky in 2023, marking the second consecutive annual decline, but state leaders say deaths remain tragically high and the fight against the drug epidemic is far from over was over. Nearly 2,000 Kentuckians died of drug overdoses last year.
Coleman recently announced plans for a statewide drug prevention program for adolescent people. Beshear said Kentucky leads the nation in the number of inpatient drug and alcohol treatment beds per capita. In Washington, Senate Republican leader Mitch McConnell has committed huge sums of federal funding to combat addiction problems in his home state.
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Associated Press writer Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.
