The attorney general’s office claims Express Scripts had access to real-time prescription data that identified red flags like doctor shopping and dangerous drug combinations, but for decades ignored the information.

“The opioid crisis is a direct result of greed and evil,” McCuskey said. “Opioid manufacturers have been held accountable, now it’s time for others who illegally profited behind the scenes to pay the price.”

McCuskey also said, “PBMs, like Express Scripts, not only fueled the crisis through their formulary placements of the pills, but they had every tool at their disposal to alert them to how addictive and destructive opioids are. Instead, for decades they ignored their own data, broke state and federal laws and put profits over people’s lives.”

The lawsuit alleges Express Scripts’ misconduct included securing preferred formulary placement for opioids in exchange for substantial rebates and fees, and weakening utilization management protocols, such as prior authorization and quantity limits.

It also claims the company ignored internal and external data signaling widespread abuse and over-prescription, and dispensed opioids through mail-order pharmacies without adequate oversight.

As one of the nation’s largest pharmacy benefit managers (PBMs), Express Scripts controlled drug access for more than 100 million Americans and maintained contracts with approximately 65,000 retail pharmacies, which is over 98% of all U.S. retail pharmacies. A PBM is a third-party company that manages prescription drug benefits for health insurers, employers and government programs.

The state’s lawsuit asserts violations of the West Virginia Consumer Credit and Protection Act, federal RICO violations, negligence, and additional equitable and common law claims.