CHARLESTON – West Virginia Attorney General J.B. McCuskey’s office has filed a lawsuit alleging a pharmacy benefit manager for its role in the opioid crisis.
The lawsuit was filed December 8 in federal court in Wheeling against United Healthcare’s Optum and related companies. The state says the PBM contributed to the oversupply of opioids in the state. West Virginia previously sued Express Scripts, another PBM.
McCuskey
In the 134-page complaint, the state accuses Optum of violating the West Virginia Consumer Credit and Protection Act and federal RICO violations as well as negligence and additional equitable and common law claims.
“Optum played a key role in the man-made medical crisis that destroyed countless lives and decimated our state,” McCuskey said. “When Optum came into West Virginia around 2010, it knew the toll that opioids were exacting on West Virginia families and communities.
“We called it a crisis. Optum saw a business opportunity. And in its greed, Optum chose to make things worse. It is time that Optum, whose critical role was previously unknown, is held accountable.”
According to McCuskey’s office, its investigation shows Optum was not only ramping up the flood of pills coming into West Virginia but “actively obstructing safeguards meant to save West Virginian lives.”
The lawsuit claims Optum conspired with drug manufactures to push phony science claiming opioids were safe and non-addictive.
“While more people were succumbing to addiction every day, Optum worked to double daily dosage limits,” McCuskey’s office says. “Optum penalized clients who tried to curb opioid abuse with dispensing restrictions, and even created a program called ‘Pay to avoid PA’ (prior authorization), in which it allowed manufacturers to pay Optum a premium to evade restrictions on opioids.”
The complaint also says Optum and other PBMs – “as the entity that sat at the center of the manufacturers, distributors, and pharmacies” – had more data and insight into the scope of the opioid crisis than any other player in the market.
“But rather than using that information to curb opioid abuse, it sold the data to manufacturers who leveraged it to sell even more deadly drugs to high-volume prescribers and pharmacies,” McCuskey’s office says.
“As we always do, before we filed this suit, Optum was given a fair opportunity to take responsibility for its choices,” McCuskey said. “Optum refused. My office will hold Optum accountable, along with anyone who helped kill West Virginians with deadly opioids.
“It’s impossible to put a price on the life of even one of my fellow Mountaineers, but our investigation shows that Optum caused billions of dollars of harm nationwide, and West Virginia will get what it is due.
“We are turning a corner in West Virginia. Last year was the first year since the beginning of the opioid crisis that our state saw a decrease in opioid-related deaths. Now is the time to finish the job started by General (Patrick) Morrisey.”
The state is being represented by Chief Deputy AG Jace H. Goins and Assistant AG Abby G. Cunningham from the AG’s office and by special assistant AGs Ryan Dovovan and Michael Hissam of Hissam Forman Donovan Ritchie in Charleston.
U.S. District Court for the Northern District of West Virginia case number 5:25-cv-00267
