LA County Sues Pharmacy Benefit Firms Over Opioid Crisis

LA County Sues Pharmacy Benefit Firms Over Opioid Crisis

Introduction

Los Angeles County has joined a growing list of local governments that have accused pharmacy benefit managers—unknown middlemen in the prescription drug business—of fueling the opioid crisis by dispersing dangerously addictive drugs throughout the country.

The county said in a complaint filed in Los Angeles County Superior Court that Express Scripts Inc. and OptumRx Inc. conspired with pharmaceutical companies to market highly addictive opioids as a reliable alternative for treating moderate pain.

In the county's emergency rooms, schools, and child welfare system, the opioid pandemic has caused chaos that is detailed in the 59-page filing: Due to their parents' addictions, children are either raised by relatives or placed in foster care. The number of overdose patients visiting the county's emergency departments is rising. Additionally, the lawsuit claims that at least six pupils overdosed at the commencement of the 2022–23 academic year.

According to the complaint, pharmacy benefit managers, or PBMs, who serve as a liaison between insurance providers and medication makers, are partially to blame for the growth in addiction. In reality, the corporations choose which medications are covered by insurance providers and how much a patient would have to pay for them. Many even operate their own pharmacies with postal delivery.

The county asserts that the corporations promoted harmful medications they knew would bring them a sizable profit rather than fighting for the lowest price. According to the lawsuit, the defendants are not just spectators to the opioid catastrophe. They contributed to the flames.

A request for comment was not answered by OptumRx or Express Scripts representatives. Express Scripts spokespersons have referred to similar lawsuits as unfounded. Express Scripts Administrators LLC, Medco Health Solutions, ESI Mail Pharmacy Service Inc., Express Scripts Pharmacy Inc., OptumInsight Inc., and OptumInsight Life Sciences Inc. are also included as defendants in the lawsuit.

Governments at the municipal, state, and federal levels have pursued major firms that spearheaded the opioid epidemic in an effort to hold them responsible for the destruction taking place in their communities as opioid fatalities continue to rise. Numerous lawsuits have been filed against opioid producers, distributors, pharmacies, and pharmaceutical benefit managers in recent years.

Similar lawsuits have been brought by counties in Ohio, Texas, and Virginia, alleging that a small number of pharmaceutical benefit administrators ignored clear indications of drug misuse and addiction.