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Philadelphia sued CVS Health, Express Scripts, Optum and other pharmacy benefit managers in federal court Thursday, claiming they perpetuated the city's opioid crisis. The city claims the companies knowingly over-distributed opioids and deceptively marketed them to increase their profits. As pharmacy benefit managers, these companies serve as intermediaries between insurers and drug manufacturers. MORE: Smoke shops in Philly suburbs mislead consumers by selling 'straight-up marijuana,' district attorney says "As the middlemen between manufacturers, insurers and pharmacies, they made it easier for powerful, addictive opioids to flood our communities," Mayor Cherelle Parker said in a statement. "We will not sit idly by while corporations boost their bottom lines at the expense of the health and safety of Philadelphians." The city is seeking compensatory and punitive damages, and court-ordered corrective action programs. CVS Health, Express Scripts and Optum had access to vast amounts of data on drug distribution, insurance claims and clinical records, and therefore were fully aware of the addiction crisis, the lawsuit claims. But they allegedly continued to prescribe and dispense opioids in exchange for rebates and other fees from drug manufacturers. "By encouraging and providing substantial assistance to the opioid manufacturers in facilitating the overprescribing and overuse of opioids ... the PBM Defendants contributed to the oversupply of opioids in Philadelphia, and the resulting damages and public nuisance," the nearly 300-page complaint says. CVS Health denied the allegations in a statement, saying "These allegations are without merit and we intend to defend ourselves vigorously." Express Scripts and Optum did not immediately return messages seeking comment Friday. The city is asking for a judge to remediate the effects of Philadelphia's opioid epidemic, which the city says has interfered with residents' public health, safety and peace and has "dramatically" increased the cost of municipal services. Fatal overdoses peaked in Philadelphia in 2022 at around 1,400, according to the lawsuit. The vast majority of those overdose deaths involved opioids and heavily impacted the city's Black and Hispanic communities, the health department reported. Fatal overdoses fell by 19% from 2023 to 2024, preliminary data show. The vast majority of overdoses involve opioids like fentanyl, a synthetic drug 100 times stronger than the highly-addictive painkiller morphine. Pennsylvania has seized nearly 50 million fentanyl doses this year, including 27 million doses from the Philadelphia region, Attorney General Dave Sunday said earlier this week. "The analogous opioid and overdose crises have touched every corner of Philadelphia, but the impact has not been distributed across our communities evenly — some neighborhoods have been ravaged by the effects of addiction stemming from the misuse of opioids for decades, the most visible of which is Kensington," Adam Geer, the city's chief public safety director, said in a statement. "... Holding those responsible who benefited for exacerbating this situation will help the city continue to right this tragic wrong."
