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 order to provide Court-enforced corrective action, programs, and communications for the named defendants.
