Utah AG targets UnitedHealth Group, Express Scripts in new opioid epidemic lawsuit
Dec 23, 2024, 2:13 PM | Updated: 6:32 pm
SALT LAKE CITY — Utah Attorney General Sean Reyes filed a lawsuit Monday, highlighting the state’s next target in an “ongoing effort” to prosecute those who “sought to profit” off the opioid epidemic.
The lawsuit names UnitedHealth Group and its pharmacy benefits manager Optum Rx, alongside the Cigna-owned Express Scripts as two of the nation’s largest PBMs and defendants in the case. According to Reyes, the PBMs quadrupled the number of prescription opioids sold annually in the U.S., which led to a “tripling of the number of Utahns who died from prescription opioid overdose.”
Data from the Centers for Disease Control and Prevention outlines the epidemic with the number of people who died from an opioid overdose in 2022, which was 10 times more than in 1999.
Reyes continued with an argument that highlighted how much data and information the two PBMs collected over the course of two decades, even quoting a statement made by an unnamed Optum Rx executive on the type of data that was obtained:
I have billions of claims, literally billions of claims. Every claim that we go through goes through an algorithm. This is all happening in realtime at the pharmacy. When you go to the pharmacy, in microseconds, I know if my patients are on a concurrent (benzodiazepine). I know what the dose is. I know what the day’s supply is. I know what other drugs they’re taking, and I can have realtime (point of sale) edits going through making sure everything is happening appropriately.
The data gathered by the defendants could have served as an alarm to the “dangerous” influx of opioid prescriptions, Reyes said, but instead it “chronicled the opioid epidemic.”
“Through access to this data, defendants knew that far greater quantities of prescription opioids had entered the market than could be legitimately, safely or appropriately used for medical purposes,” the suit alleges.
The action comes after pharmacists in the state called on state leaders and federal lawmakers for help in what the lawsuit called the “worst human-made epidemic in modern medical history.” It also follows a similar lawsuit made by the state against Kroger for its involvement, which settled in November.
A larger discussion online involved UnitedHealth Group’s benefits business’ after its CEO was fatally shot by a gunman who police believe was possibly motivated by an anger with “parasitic” health insurance companies.
