Attorney General Mayes Sues Pharmacy Benefit Managers Express Scripts and Optum for Contributing to Arizona’s Opioid Crisis

PHOENIX – Attorney General Kris Mayes today announced that the Attorney General’s Office 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 complaint 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.

According to the complaint, Express Scripts and Optum used their market power and unique access to real‑time prescription data to promote increased opioid prescribing while concealing material information about the risks associated with opioids and the financial arrangements that shaped their formulary and utilization‑management decisions. The PBMs allegedly assured clients and the public that their formularies and safety controls prioritized clinical appropriateness, yet in practice prioritized maximizing rebate revenue 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,” said Attorney General Mayes. “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 includes allegations that the PBM Defendants collaborated with opioid manufacturers—particularly Purdue Pharma—to secure unrestricted, preferred formulary status for OxyContin and other opioids. In exchange for confidential payments from opioid manufacturers like Purdue Pharma, the PBMs allegedly agreed not to apply basic utilization‑management tools such as prior authorization or step therapy that would have reduced opioid dispensing.

The PBMs also allegedly partnered with manufacturers to distribute misleading educational materials downplaying addiction risks and sold detailed prescriber and claims data to manufacturers, enabling targeted marketing campaigns aimed at high‑volume prescribers.

“We allege that these PBMs had access to granular data indicating potentially illegitimate prescriptions, doctor‑shopping, and dangerous dosage patterns, but prioritized speed and profitability in their mail‑order operations over basic steps to prevent the diversion of opioid medication,” said Attorney General Mayes.

The Complaint alleges other deceptive and unfair practices and material omissions under the Arizona Consumer Fraud Act, including:

• Misrepresenting that formularies and safety controls were designed around safety and efficacy rather than profit.
• Refusing to implement basic utilization‑management safeguards for opioids despite claiming they would do so.
• Participating in deceptive opioid‑marketing efforts with manufacturers.
• Concealing rebate agreements and other financial incentives that created conflicts of interest in formulary design.
• Failing to fulfill legal obligations as mail‑order pharmacies.

The Attorney General’s complaint alleges that the PBMs’ conduct significantly increased the availability of opioids in Arizona, contributing to addiction, overdose, and death, and imposing billions of dollars in healthcare, emergency‑response, and societal costs.

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

If you believe you have been a victim of consumer fraud or unfair practices, you can file a consumer complaint by visiting the Attorney General’s website at www.azag.gov/consumer. If you need a complaint form sent to you, you can contact the Attorney General’s Office in Phoenix at (602) 542‑5763, in Tucson at (520) 628‑6648, or outside the Phoenix and Tucson metro areas at (800) 352‑8431.