West Virginia Attorney General JB McCuskey has filed a new lawsuit against a pharmacy benefit manager (PBM) for its role in the opioid crisis in West Virginia. The suit alleges that United Healthcare’s PBM, Optum, and its affiliated companies contributed to the widespread oversupply of opioids into West Virginia communities.
“Optum played a key role in the man-made medical crisis that destroyed countless lives and decimated our state,” Attorney General McCuskey said. “When Optum came into West Virginia around 2010, it knew the toll that opioids were exacting on West Virginia families and communities. We called it a crisis. Optum saw a business opportunity. And in its greed, Optum chose to make things worse. It is time that Optum, whose critical role was previously unknown, is held accountable.”
The Attorney General’s investigation has revealed that in the midst of the opioid crisis, Optum was not only ramping up the flood of pills coming into West Virginia, but actively obstructing safeguards meant to save West Virginian lives. The State’s suit alleges that, long after the dangers of opioids were known, Optum conspired with drug manufactures to push phony science claiming opioids were safe and non-addictive. While more people were succumbing to addiction every day, Optum worked to double daily dosage limits. Optum penalized clients who tried to curb opioid abuse with dispensing restrictions, and even created a program called “Pay to avoid PA" (prior authorization), in which it allowed manufacturers to pay Optum a premium to evade restrictions on opioids.
The suit further alleges that, as the entity that sat at the center of the manufacturers, distributors, and pharmacies, PBMs like Optum had more data and insight into the scope of the opioid crisis than any other player in the market. But rather than using that
information to curb opioid abuse, it sold the data to manufacturers who leveraged it to sell even more deadly drugs to high-volume prescribers and pharmacies.
“As we always do, before we filed this suit, Optum was given a fair opportunity to take responsibility for its choices. Optum refused. My office will hold Optum accountable, along with anyone who helped kill West Virginians with deadly opioids. It’s impossible to put a price on the life of even one of my fellow Mountaineers, but our investigation shows that Optum caused billions of dollars of harm nationwide, and West Virginia will get what it is due,” McCuskey said. “We are turning a corner in West Virginia. Last year was the first year since the beginning of the opioid crisis that our state saw a decrease in opioid-related deaths. Now is the time to finish the job started by General Morrisey.”
The lawsuit was filed Monday in the United States District Court for the Northern District of West Virginia. This is the second lawsuit filed against a PBM, with the Attorney General’s office previously suing Express Scripts.
The State asserts violations of the West Virginia Consumer Credit and Protection Act, federal RICO violations, negligence, and additional equitable and common law claims.
The lawsuit can be found here.
###