Attorney General Lynn Fitch filed a lawsuit Thursday against pharmacy benefit managers that alleges the companies fueled the opioid epidemic by working with manufacturers to increase sales of the addictive drugs and magnify their profits. 

“They colluded with the opioid manufacturers, placed profits over safety, and engaged in a clandestine scheme to increase the sale of prescription opioids, despite the known dangers of these drugs,” the filing states. 

The suit names Optum, Evernorth Health, Express Scripts and several of the companies’ subsidiaries as defendants. Optum is owned by UnitedHealth Group, and Evernorth Health and Express Scripts are owned by The Cigna Group. 

Pharmacy benefit managers are the middlemen between pharmacies, drug manufacturers and insurers that negotiate drug prices, process claims for prescriptions and manage retail pharmacy networks. 

The filing alleges that the companies conspired with Purdue Pharma and other opioid manufacturers to deceptively market and oversupply opioids to Mississippians. It also claims the defendants knew they were dispensing more prescription opioids than could be legitimate, contributing to an illegal secondary market. 

Mississippi has the fourth-highest rate of opioid prescription rates in the nation. Sixty-four opioid prescriptions were dispensed per 100 people in the state in 2022, according to the CDC. 

Mississippi is not the first state to file a lawsuit against pharmacy benefit managers for their alleged role in the opioid crisis. In June, Arkansas sued Express Scripts, Optum and their subsidiaries, citing similar claims.

Pharmacy benefit managers have faced increased scrutiny following a recent Federal Trade Commission report that suggested the companies “may be profiting by inflating drug costs and squeezing Main Street pharmacies.”

Consolidation within the industry has led to the three largest pharmacy benefit managers – UnitedHealth Group’s OptumRX, Cigna’s Express Scripts and CVS Health’s CVS Caremark – to manage nearly 80% of prescriptions filled in the U.S. in 2023, according to the report. 

In June, Fitch joined an amicus brief in support of an Oklahoma law to strengthen regulations on pharmacy benefit managers, along with 31 other states.

Lawsuits filed by Fitch against companies that played a role in amplifying the opioid epidemic will yield $367 million in settlements over the next 18 years, according to the Attorney General’s Office. 

“I will continue to hold these companies accountable for the role that they have played in destroying so many lives through their unfair, deceptive practices so that our state can heal from this crisis and guard against it ever happening again,” Fitch said. 

A bill aimed at regulating pharmacy benefit managers in Mississippi failed during this year’s legislative session.

The Mississippi House of Representatives convened a committee aimed at studying possible changes to laws regulating pharmacy benefit managers. It will make recommendations to the Legislature for next year’s session. The committee is chaired by Rep. Jerry Turner (R-Lee) and Rep. Beth Waldo (R-Ponotoc) and began meeting this summer.

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