The state of Kentucky has filed a lawsuit against the pharmacy benefit manager Express Scripts, accusing it of worsening the deadly opioid crisis in the state.
Kentucky’s Attorney General, Russell Coleman, filed the 83-page lawsuit in Jessamine County Circuit Court on Sept. 25 against the St. Louis-based firm and its affiliated organizations.
According to the lawsuit, the opioid crisis was “fueled and sustained by those involved in the supply chain of opioids, with manufacturers, distributors, pharmacies, and Pharmacy Benefit Managers (PBMs), including Express Scripts, each playing a role.”
PBMs manage prescription drug coverage for health insurers and employers, who provide coverage for hundreds of millions of Americans and decide which drugs make a plan’s formulary or list of covered medications.
They also can determine where patients go to access their prescriptions.
Kentucky’s lawsuit states that while dozens of PBMs exist throughout the United States, only a “select few,” including Express Scripts, dominate the market and wield massive influence in the availability, dispensing, and pricing of prescription drugs.
Express Scripts’ network includes 64,000 pharmacies across the country, the legal filing notes.
The lawsuit alleges Express Script and its affiliated organizations “colluded” with opioid manufacturers in deceptive marketing schemes to alter perceptions of opioids and increase sales of the addictive drugs.
That resulted in “the worst man-made epidemic in modern medical history,” and an “epidemic of addiction, overdose, and death caused by an oversupply of opioids flooding communities from powerful corporations who sought to profit at the expense of the public,” the lawsuit states.
Kentucky has been at the epicenter of the crisis with some of the nation’s highest overdose death rates, the lawsuit notes.
Express Scripts said in a statement to multiple media outlets that it will “vigorously contest these baseless allegations in court.”
Overdose Deaths Surge in Kentucky
Coleman called the opioid-fueled drug crisis the “greatest tragedy of our lifetime” that has “stolen loved ones, drained scarce public resources, and inflicted generational harm on Kentucky communities large and small.”In 2020, Kentucky had the second-highest drug overdose death rate at 49.2 opioid-related deaths per 100,000 residents, behind only West Virginia, according to the lawsuit. One year later, Kentucky’s drug overdose death rate increased to 55.6 opioid-related deaths per 100,000 residents, the fourth-highest death rate in the country.
The number of overdose deaths decreased slightly in 2023.
“The role of Express Scripts in causing the opioid epidemic has been largely concealed from public view,” the lawsuit states. “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.”
Kentucky’s lawsuit further accuses Express Scripts of taking steps to restrict tools that would have limited opioid prescribing and dispensing, failing to report or address the “suspicious volume ”of opioids flowing into Kentucky and the rest of the country; and dispensing opioids through mail order pharmacies without effective controls, in violation of Kentucky and federal law.
The state further claims Express Scripts “ignored evidence of misuse, addiction, and diversion” and used their data to boost profits and manufacturers’ sales “at the expense of public health and safety.”
Kentucky’s lawsuit seeks $2,000 for each willful violation of the Kentucky Consumer Protection Act, along with any other penalties the court deems appropriate.
The state is also seeking a jury trial on the matter.
