Arkansas Sues 2 PBMs for Their Role In Opioid Epidemic

At the end of June 2024, Arkansas Attorney General Tim Griffin announced that he filed lawsuits against 2 pharmacy benefits managers (PBMs)–Express Scripts and Optum–for their role in contributing to the opioid epidemic in the state.

The lawsuit alleges that the PBMs financially benefitted from the opioid crisis by negotiating favorable deals with drug manufacturers while doing nothing to curb the excessive and unnecessary prescribing of opioids.

According to a press release from Attorney General Griffin, between 2006 and 2014, the state was “flooded with almost 1.5 billion units of addictive opioids. By 2016, Arkansas had the second highest opioid prescription rate in the nation, with 114.6 opioids being dispensed for every 100 Arkansans¬–nearly twice the national average and enough to supply every man, woman, and child in Arkansas 78 opioid doses each.” The lawsuit itself notes that as the opioid use increased, so has the death toll in the state due to overdoses. According to the Attorney General’s complaint, there were 546 overdoses in Arkansas in 2020, and 637 in 2021.

The suit, filed in Pulaski County Circuit Court, alleges that the defendants operated online and mail order retail pharmacies which dispensed huge amounts of opioids without following state or federal laws, and that they took actions to increase opioid use such as placing opioids on lower tiers of their formularies, controlling what less addictive pain medications were available to patients, and making false representations about favorable health outcomes when they were only trying to increase profits. The lawsuit also maintains that the PBMs were aware of the opioid problem in the state yet failed to take any actions to curb it.

The lawsuit seeks to hold the PBMs accountable for creating a public nuisance, as well as a public health crisis, in the state. It also charges the PBMs with negligence in failing to follow reasonable care with addictive and dangerous opioids, and unjust enrichment in seeking to benefit from causing addiction.

“Pill by pill and dollar by dollar, PBMs enabled the opioid epidemic in Arkansas,” said Attorney General Griffin in a statement. “Today, we begin the process of holding them accountable for their roles in a crisis that has ravaged our state–a crisis they helped cause, contributed to, and furthered.”

Many states and cities have launched lawsuits against PBMS in the last few years, although less frequently due to opioids, but rather much more often due to price fixing. In 2022, Arkansas sued three drug manufacturers, accusing them of conspiring with PBMs to inflate the cost of insulin. That case is still pending.

References

Attorney General Griffin sues pharmacy benefit managers for roles in Arkansas opioid epidemic. News release. Tim Griffin, Attorney General of Arkansas. June 24, 2024. Accessed July 2, 2024. https://arkansasag.gov/news_releases/attorney-general-griffin-sues-pharmacy-benefit-managers-for-roles-in-arkansas-opioid-epidemic/

State of Arkansas, ex rel. Tim Griffin, Attorney General v Optum, Inc and Express Scripts, et al. 60CV-24. Pulaski County, AR (Cir Court, Civil Division); 2024