Kentucky sues Express Scripts, alleging it helped fuel state's opioid crisis

Kentucky’s attorney general is suing the pharmacy benefit manager (PBM) Express Scripts over its role in “worsening” the state’s opioid crisis. 

In the complaint filed in state court, Attorney General Russell Coleman (R) argued Express Scripts “is at the center of” the opioid dispensing chain that helped fuel the crisis. 

Coleman claimed the company and its affiliates colluded with manufacturers in deceptive marketing practices to increase opioid sales. He said Express Scripts also ignored evidence of addiction and misuse found in its own claims data. 

“Defendants ignored evidence of misuse, addiction, and diversion and used their data to boost Express Scripts’ profits and manufacturers’ sales at the expense of public health and safety,” the complaint stated. 

Coleman said Kentucky has been at the epicenter of the opioid crisis and has some of the highest rates of overdose deaths. Last year alone, 1,984 Kentuckians died of a drug overdose, he said. 

“The role of Express Scripts in causing the opioid epidemic has been largely concealed from public view,” the complaint stated.  

"But it has now become clear that, for no less than the last two decades, Express Scripts has had a key role in facilitating the oversupply of opioids through intentional conduct that disregarded needed safeguards in order to increase the prescribing, dispensing, and sales of prescription opioids.” 

Express Scripts said it has a long history of working with its health plan sponsor clients across the country.  

“We will vigorously contest these baseless allegations in court,” the company said in a statement to The Hill.  

In recent years, lawmakers and regulators have increasingly scrutinized the business practices of PBMs, the opaque intermediaries in the center of the pharmaceutical distribution system.  

PBMs negotiate the terms and conditions of access to prescription drugs for hundreds of millions of Americans. They are responsible for negotiating prices with drug companies, paying pharmacies and determining which drugs patients can access and how much they cost.  

Coleman’s lawsuit follows one filed by Arkansas, which in July sued Express Scripts and Optum, alleging PBMs contributed to the dramatic rise in the abuse of painkillers. 

Kentucky’s lawsuit says the state is entitled to $2,000 for each willful violation of the Kentucky Consumer Protection Act. 

“Express Scripts and the other pharmacy benefit managers amassed an unprecedented level of power, using it to push opioid pills and conceal unlawful activity,” Coleman said in a statement. “They must be held to account for profiting off Kentucky families’ pain.”