Dustin Steinhoff, News Editor

Express Scripts is one of the many pharmaceutical companies being sued by a group of Missouri counties seeking payment for the money they have spent trying to fight the “opioid epidemic.”

On Aug. 1, 10 Missouri counties filed a 274-page lawsuit in St. Louis Circuit Court against 49 pharmacies, and opioid distributors and manufacturers. The lawsuit claims pain prescriptions have been branded by manufacturers and distributors as solutions for long-term and chronic pain in order to increase drug sales. Additionally, the counties claim the companies did not inform the Missouri State Pharmaceutical Board and Drug Enforcement Agency when receiving and filling suspicious orders.

The counties involved in the lawsuit are Cape Girardeau, Christian, Crawford, Greene, Iron, Jasper, Jefferson, Joplin, Taney, and Washington. Among the 49 defendants are companies such as Walgreens, CVS, Purdue Pharma, and St. Louis-based company Express Scripts.

The plaintiffs claim they should be reimbursed for the costs the opioid epidemic has caused them due to the autopsies, law enforcement, medical care, and family protective services needed due to opioid overdoses.

According to the Centers for Disease Control and Prevention, the number of overdose deaths involving opioids in 2016 was five times higher than in 1999. The average number of Americans who die every day from an opioid overdose is 115.

Brian Henry, vice president of corporate communications at Express Scripts, provided the company’s official response: “Express Scripts leads the industry with solutions to reduce abuse of opioids. We intend to vigorously defend ourselves against these allegations.”

John Garvey, an attorney from the private law firm Carey Danis & Lowe, is one of the attorneys working with the various counties on the case.

“Our lawsuit is against 49 defendants,” Garvey said. “Not only manufacturers, but distributors, pharmacies, and prescription benefit managers such as Express Scripts.”

Garvey claims the lawsuit is based upon the liability of the corporations, the first of which being the mislabeling of opioids.

“The first [liability] is the failure to disclose or the misbranding of the opioid, beginning with Purdue Pharmaceutical where the label for opioids provides that it is only meant for postsurgical pain and cancerous pain,” Garvey said.

Despite being labeled as a prescription for such pains, Garvey claims the drugs were misrepresented by the company’s claims and marketed towards the chronic market pain and general practitioner doctors. Garvey also claims the companies endorsed the drugs as safe, effective, you can function normally on the drug, is was not addictive, raising the dosage was not dangerous, and there were no withdrawal symptoms, despite not being true.

“All those things are false. All of those things the companies knew were false. But they aggressively marketed to the key opinion leaders and bogus front groups that they had funded that they had not told the public they were funding,” Garvey said.

Garvey also claims Express Scripts and the other companies did not report certain red flags when fulfilling opioid prescriptions.

“The second level of liability is where companies like Express Scripts, have a duty under the law to report suspicious activity, meaning high numbers of opioids going to a particular geographical location or patient. None of the manufacturers, distributors or pharmacies ever called the DEA or the State Board of Pharmacies to report this,” Garvey said. “Express Scripts and other pharmacies failed to have adequate control in dispensing their drugs and knew that most of these prescriptions they were dispensing were for non-medical purposes and that they were for addicts.”

According to Garvey, it will be a couple of years before there is a trial. Once the trial occurs, there will be a single verdict applied to Express Scripts and the other companies involved in the lawsuit.

Express Scripts has a large presence on the UMSL campus. Express Scripts opened its world headquarters on campus in 2007. George Paz, former Express Scripts CEO and current board chairman for Express Scripts, graduated from UMSL and is currently serving a three-year term as president of the Chancellor’s Council at UMSL. In 2011, the Computer Center Building was renamed Express Scripts Hall.