Attorney General Fitch is suing pharmacy executives over the opioid epidemic

• Pharmacy benefit managers were designed to help reduce prescription drug costs. In the new lawsuit, Mississippi AG Lynn Fitch said they colluded with drug manufacturers to sell addictive opioids.

Since taking office, Mississippi Attorney General Lynn Fitch has been involved in a series of statewide lawsuits and disputes with manufacturers, distributors and sellers of opioids. On Thursday, Fitch filed a lawsuit in Hinds County Chancery Court to identify a new target: pharmacy benefit managers (PBMs).

The Fitch lawsuit alleges that PBMs colluded with opioid manufacturers to flood the market with cheap opioids, which led to the addiction problem. The complaint describes the opioid crisis as “the worst man-made epidemic in modern medical history,” and has “ravaged Mississippi.”

The pharmacy benefits system was designed to reduce the cost of prescription drugs for consumers. Because they work with pharmacy networks that buy drugs in bulk, PBMs retain the power to negotiate lower prices and discounts with drug manufacturers. They also create “screenings,” which are lists of approved drugs designed to identify low-cost, selective options for treating specific conditions.

Fitch’s lawsuit alleges that two of the nation’s three largest PBMs, Optum and Express Script, received discounts from opioid manufacturers that made opioids cheaper than prescriptions. other safe. The complaint alleges that as part of this reduction arrangement, PBMs agreed to list opioids on formularies for pain management while ignoring safety concerns.

The Biden White House has been targeting PBMs in recent years. The Federal Trade Commission, in July of this year, released a report arguing that PBMs have become anti-competitive due to industry consolidation and direct ties to pharmacies and health insurance plans. US House Republicans have also questioned the effectiveness of PBMs in reducing drug costs in recent debates.

The Attorney General’s case adopts some of the same arguments.

In a statement announcing the lawsuit, Fitch said the opioid epidemic is tearing families and communities apart in Mississippi.

“I will continue to hold these companies accountable for the role they have played in destroying the lives of many people through their unfair, deceptive practices so that our government can recover from this crisis and ensure that never happen again,” said Attorney General Fitch.

Fitch’s office noted that in the past few years, the Attorney General has entered into negotiations with more than a dozen companies – manufacturers, distributors, pharmacy chains, and even companies who created marketing plans – who participated in the creation and development of opioids. accident. In total, the AG said those cases will bring north of $367 million to Mississippi over the next 18 years.

Other side

According to the Pharmaceutical Care Management Association (PCMA), a trade association that represents PBMs, more than 275 million Americans have health insurance that includes PBM-administered drug plans, ranging from business to Medicare and Medicaid.

PCMA estimates that PBM negotiations for lower drug prices will save health plan sponsors and consumers more than $1 trillion in prescriptions over the next decade. That works out to $1,040 annually for each patient and their insurance provider.

The industry also states that the formulary lists are produced with the recommendations of independent businessmen, doctors and physicians.

For example, a white paper published by Express Script, one of the two PBMs cited by Fitch, states that its main concern in developing its drug list is “the right product , not cost,” and that its “effective remedies” are “based on independent physician reviews.”

It also notes that “the prescribing physician always makes the final decision regarding the medication treatment of each patient.”