Arizona sues pharmacy benefit managers over opioid crisis allegations

Arizona Attorney General Kris Mayes has filed a consumer fraud lawsuit against pharmacy benefit managers (PBMs) Express Scripts and Optum. The state alleges the companies contributed to the opioid crisis over two decades by using their influence over prescription coverage to favor revenue-generating arrangements over safety safeguards. The complaint claims the companies worked with manufacturers, including Purdue Pharma, to secure preferred coverage for drugs like OxyContin while avoiding controls such as prior authorization and step therapy.

Arizona is seeking financial restitution, civil penalties, and court-ordered changes to business practices. The lawsuit highlights how PBMs influence drug pricing and coverage decisions.

This legal action coincides with a broader trend of state-level PBM reform across the United States. Lawmakers in states including California, Texas, Arkansas, Iowa, North Carolina, and Delaware have enacted legislation to address issues such as spread pricing, rebate opacity, and pharmacy reimbursement. These reforms aim to increase transparency and limit the influence of PBMs on the pharmaceutical supply chain.