City of Philadelphia Files Lawsuit Against Pharmacy Benefit Managers Including CVS Caremark, Express Scripts, and Optum

The lawsuit alleges the companies knowingly perpetuated the opioid public health crisis in Philadelphia by conspiring with manufacturers to expand opioid market and use

PHILADELPHIA - Today, the City of Philadelphia with co-counsel Dilworth Paxson; Baron & Budd, P.C.; Feldman Shepherd LLP; David Kairys; Sheller, P.C.; and Sacks Law, LLC, filed a lawsuit alleging that the named defendant Pharmacy Benefit Managers (PBMs) played a role in creating and perpetuating Philadelphia's opioid crisis through deceptive marketing and overdistribution of opioids in violation of Philadelphia's Consumer Protection Ordinance and federal and state controlled substance laws.

PBMs act as intermediaries between health insurance plans, pharmacies, and drug manufacturers and manage prescription drug benefits for health plans,such as employer-sponsored health insurance like the City of Philadelphia's. The PBM Defendants are the three largest PBMs in the United States, collectively managing prescription drug coverage for 200+ million covered lives and processing billions of claims per year.

PBM Defendants have, for at least two decades, actively worked with opioid manufacturers to increase the prescribing, dispensing, and sales of OxyContin and other prescription opioids. While misrepresenting their efforts to promote the safe use and appropriate prescription of opioid medications, the defendant PBMs maximized their profits by conspiring with opioid manufacturers to give opioid medication favorable placement on covered drug lists in exchange for rebates and other fees.

As the opioid addiction crisis worsened, the defendant PBMs failed to take timely action to address the epidemic they helped to create. Even after acknowledging the epidemic and implementing some protocols to limit access to opioids, the defendants continued to market and encourage liberal prescription of the drugs.

As Philadelphia continues efforts to remediate widespread opioid addiction and the public health implications of the epidemic, the City is seeking relief including compensatory and punitive damages, and an injunctive orderto provide Court-enforced corrective action, programs, and communications for the named defendants.

"Even while knowing the dangers of opioid overuse, these companies chose profit over people," said Mayor Cherelle L. Parker. "As the middlemen between manufacturers, insurers, and pharmacies, they made it easier for powerful, addictive opioids to flood our communities. My administration is committed to holding every driver of this crisis accountable - at every level of the supply chain. We will not sit idly by while corporations boost their bottom lines at the expense of the health and safety of Philadelphians. The lawsuit is about justice and relief for the families and neighborhoods still suffering from pain and loss caused by this epidemic."

"In collusion with manufacturers, these companies actively worked to maximize their profits through sales of prescription opioids. They systematically rejected safeguards to prevent overprescription of powerful, addictive medications and put lives at risk while misrepresenting their commitment to public safety," said Renee Garcia, City Solicitor. "These companies watched as the opioid epidemic ravaged Philadelphia communities and recklessly continued to fuel widespread addiction. We want them to stop inflicting damage on our communities and to pay for the crisis they've had a major role in causing."

"The analogous opioid and overdose crises have touched every corner of Philadelphia, but the impact has not been distributed across our communities evenly - some neighborhoods have been ravaged by the effects of addiction stemming from the misuse of opioids for decades, the most visible of which is Kensington, but it can just as frequently be hidden behind closed doors," said Chief Public Safety Director Adam Geer."This Administration through the Office of Public Safety is leading a multipronged public safety approach to address conditions on the ground including targeted investments in community organizations, collaboration with City partners to deliver direct service and wellness recovery options which have lowered fatal overdoses, and restoration of norms through enforcement that has resulted in historic drops in crime. But we cannot do it alone, and holding those responsible who benefitted from exacerbating this situation will help the City continue to right this tragic wrong."

Click here to read the complaint.

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