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THURSDAY, April 19, 2018 (HealthDay News) — A first opioid lawsuit is targeting pharmacy benefit managers (PBMs), according to a report published in Managed Healthcare Executive<\/i>.<\/p>\n
Noting that until now, PBMs have not been sued for the opioid crisis, in February, a south Texas county included the three largest PBMs in a nationwide lawsuit, which focused on the opioid epidemic. Their inclusion was due to their role in allowing access to prescription opioids.<\/p>\n
PBMs are not expected to question physician’s therapeutic choice and do not have the same professional obligations as pharmacists do. However, they do have a lot of power, acting as the middlemen between doctor, patient, and pharmacy. They also have the most to gain from the cost of a prescription. PBMs are likely to be increasingly targeted in litigation. Health plans are contracting with PBMs for the benefit of patients, and as such, the PBMs have a responsibility to protect patients from harm. Allegations are likely to be that PBMs allowed a greater amount of opioids to be permitted in communities than could be supported based on the legitimate medical needs of the community.<\/p>\n
“While it takes some creativity to do something new (like looking at PBMs) as a responsible party, my hunch is that other lawyers are likely to learn from this and will be interested in a potential additional source of settlement funds,” Harry Nelson, from Nelson Hardiman, LLP, a health care law firm, said in the article.<\/p>\n