West Virginia sues pharmacy benefit manager for contributing to opioid crisis

CHARLESTON, W.Va. (WBOY) — West Virginia’s attorney general said in a press release Monday that “opioid manufacturers have been held accountable, now it’s time for others who illegally profited behind the scenes to pay the price.”

Attorney General JB McCuskey announced his office is suing Express Scripts (now Evernorth Health) on behalf of the state for its role in the oversupply of opioids in West Virginia. According to McCuskey’s office, Express Scripts, which is a pharmacy benefit manager (PBM), “played a central role in the widespread oversupply of opioids” in the state.

PBMs are third-party companies that manage prescription drug benefits, including for health insurers, employers and government programs.

“PBMs, like Express Scripts, not only fueled the crisis through their formulary placements of the pills, but they had every tool at their disposal to alert them to how addictive and destructive opioids are,” McCuskey said in the release.

The lawsuit filed in the U.S. District Court for the Northern District of West Virginia alleges that Express incentivized opioid sales at the expense of clinical judgment, weakened protocols that prevented over-prescribing, ignored signals of widespread abuse, and violated West Virginia and controlled substances laws by dispensing opioids through mail-order pharmacies.

“Express Scripts controlled drug access for more than 100 million Americans and maintained contracts with approximately 65,000 retail pharmacies—over 98% of all U.S. retail pharmacies,” the release from McCuskey’s office said.