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Boston Lawsuit Eyes PBMs as Culpable in Opioid Epidemic

The city of Boston is intensifying its legal efforts against the opioid epidemic by filing a lawsuit targeting pharmacy benefit managers (PBMs). The city’s complaint alleges that these PBMs collaborated with drug makers to promote the use of prescription opioids like Oxycontin, contributing to the emergence of an illegal market for these potent drugs.

Large companies like Express Scripts Pharmacy, ESI Mail Pharmacy Services, and Optum Rx are named defendants in the lawsuit, with the city claiming that these PBMs acted as “gatekeepers to the opioid market.

Zeroing In on PBM Optum Rx

Optum Rx, in response to the accusations, denied any wrongdoing and asserted its commitment to addressing the opioid issue. The lawsuit involves the city of Boston, its Public Health Commission, and the Boston Housing Authority as plaintiffs. While most lawsuits related to the opioid epidemic have targeted manufacturers, distributors, and retailers, Boston’s case stands out for focusing on PBMs.

Boston’s lawsuit alleges that PBMs colluded with drug makers to maximize profits by prioritizing the prescription of addictive opioids despite known risks. The city claims that these companies benefited from deals with drug makers that facilitated the prescription of opioids in exchange for financial incentives. Additionally, the lawsuit accuses PBMs of neglecting their data, indicating widespread opioid prescribing and failing to address the consequences of the escalating opioid use.

The complaint presents grim statistics on the impact of the opioid epidemic in Boston, including 251 overdose deaths in 2021 and a surge in police and emergency medical responses to overdoses. The lawsuit argues that the conduct of PBMs contributed to the proliferation of opioids in the city, leading to devastating consequences for residents.

The First of Many Lawsuits?

This lawsuit, if successful, could pave the way for other lawsuits in the future.

Legal expert Adam Zimmerman sees the Boston lawsuit as a potential “bellwether case,” setting a precedent for other municipalities holding companies accountable for the damage caused by the overprescribing of opioid painkillers. Zimmerman emphasizes that the opioid epidemic resulted from a regulatory breakdown and institutional failures across the entire distribution chain, making it a complex issue with widespread implications.