Los Angeles County has entered the growing list of local governments leveling allegations against pharmacy benefit managers, the relatively obscure intermediaries within the prescription drug industry, claiming that they played a significant role in exacerbating the opioid crisis by facilitating the widespread distribution of highly addictive medications.
In a lawsuit filed on Wednesday in Los Angeles County Superior Court, the county contends that Express Scripts Inc. and OptumRx Inc. engaged in collusion with drug manufacturers to promote dangerously addictive opioids as a safe and moderate pain management option.
In a comprehensive 59-page legal filing, the county outlines the devastating consequences that the opioid crisis has unleashed upon its emergency rooms, educational institutions, and child welfare system. Tragic outcomes include children being raised by relatives or placed in foster care due to their parents’ addictions, an increasing number of overdose patients in the county’s emergency departments, and reports of at least six students overdosing at the beginning of the 2022-23 school year, according to the lawsuit.
The lawsuit contends that pharmacy benefit managers, commonly referred to as PBMs, which serve as intermediaries between drug manufacturers and insurance providers, bear partial responsibility for the surge in addiction cases. These companies operate behind the scenes, influencing which drugs are covered by insurance policies and the financial burden placed on patients. Many PBMs also operate their own mail-order pharmacies.
Rather than advocating for the lowest drug prices, the county alleges that these companies utilized “deceptive and hazardous marketing” strategies to promote dangerous drugs they knew would yield substantial profits.
The lawsuit states, “Defendants are not passive observers in the opioid crisis; they actively contributed to its escalation.”
As of Friday, representatives for Express Scripts and OptumRx had not responded to requests for comment. Spokespeople for Express Scripts have previously dismissed similar lawsuits as lacking merit.
The lawsuit also identifies six related companies: Express Scripts Administrators LLC, Medco Health Solutions, ESI Mail Pharmacy Service Inc., Express Scripts Pharmacy Inc., OptumInsight Inc., and OptumInsight Life Sciences Inc.
With opioid-related deaths continuing to rise, governments at the local, state, and federal levels have taken legal action against major corporations implicated in the opioid crisis in an effort to hold them accountable for the devastation affecting their communities. In recent years, numerous lawsuits have been filed against opioid manufacturers, distributors, pharmacies, and pharmacy benefit managers.
Counties in Ohio, Texas, and Virginia have all initiated comparable legal actions, alleging that a small group of pharmacy benefit managers turned a blind eye to evident signs of addiction and drug abuse.
The county argues that Express Scripts and OptumRx held a unique position for tracking the epidemic’s growth. According to the county’s allegations, the companies possessed data on opioid usage for approximately 166 million individuals covered by the insurance providers with which they had contracts, meaning they had real-time insights into how opioids were being misused among nearly half of the U.S. population.
The county accuses the companies of passively witnessing the unfolding opioid epidemic while taking no action.
“Instead of reporting instances of improper prescription and sales, which were uniquely evident in the extensive data they collected, the defendants ignored evidence of misuse, addiction, and diversion, and utilized their data to bolster their profits and the manufacturers’ sales at the expense of public health and safety,” the lawsuit asserts.
