Arizona AG Kris Mayes sues pharmacy benefit managers for contributing to opioid epidemic

Arizona Attorney General Kris Mayes has filed a consumer fraud lawsuit against Express Scripts and Optum, two of the largest pharmacy benefit managers (PBMs) in the nation.

The attorney general’s office alleges that, for more than two decades, the PBM defendants engaged in deceptive, unfair and unlawful practices that substantially contributed to the opioid epidemic in Arizona.

These practices included claims that the PBMs used their market power and access to real-time prescription data to promote increased opioid prescribing, while simultaneously concealing information about the risks of opioid use.

According to the complaint, the PBMs allegedly told clients and the public that their drug coverage lists and safety rules put patients’ medical needs first, but instead focused on getting the most rebates and other financial benefits from opioid manufacturers.

“These pharmacy benefit managers repeatedly violated Arizona law and placed the health and safety of Arizonans at risk,” Mayes said in a press release. “By designing formularies and safety programs around profit instead of patient protection, Express Scripts and Optum helped fuel the opioid crisis in our state. Arizona families deserve accountability for conduct that contributed to addiction, overdose and death.”

The complaint further alleges that the PBM defendants received confidential payments from opioid manufacturers in exchange for not applying basic utilization‑management tools — such as prior authorization or step therapy — on products like OxyContin, which led to increased opioid dispensing. The increased dispensing, in turn, contributed to addiction, overdose and death, imposing billions of dollars in health care, emergency‑response and societal costs, according to the lawsuit.

This lawsuit comes just over a week after the attorney general’s office went after a kratom product commonly sold in Arizona gas stations. Kratom is a substance similar in structure to opioids.

The aim of the lawsuit is to seek restitution, civil penalties, injunctive relief, disgorgement of profits, corrective programs and a court order prohibiting the PBMs from continuing the challenged practices.

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