The top pharmacy benefit management (PBM) companies, like CVS Caremark, Express Scripts Inc., and OptumRx Inc., should be required to follow opioid prescribing guidelines consistent with the Centers for Disease Control and Prevention (CDC) in light of the opioid epidemic, according to a new motion in the growing opioid multidistrict litigation (MDL).
The motion for preliminary injunction came out of two MDL cases – one filed by union benefit plans for Ohio residents, and another filed by Webb County, Texas. PBMs have, for the most part, flown under the radar in the opioid MDL, until now.
The opioid MDL consolidated in the U.S. District Court for the Northern District of Ohio includes more than a thousand cities, counties, states and even Native American tribes accusing opioid manufacturers, drug distributors and pharmacies of contributing to the opioid epidemic, which is costing communities not only in lives but in economic burden. Communities face expenses including increased health care costs for addicts and babies born addicted to the powerful painkillers, as well as foster care for children those addicted to the drugs neglect.
PBMs decide whether and how drugs should be covered by employers and insurance companies. The motion presented last week suggests that there may be shortcomings in their policies that are lax on opioids and allow for “largely unchecked prescribing of opioids for chronic pain,” allow excessive quantities of opioids to be dispensed, and improperly restrict patients’ access to opioid withdrawal treatments.
A preliminary injunction requiring PBMs to adopt guidelines for opioids could be another step in easing the squeeze of the opioid crisis, the union plans and Webb County suggested in their motions.