(CLEVELAND) – A U.S. District Court order takes strong first steps to address the opioid crisis, setting common sense lower limits for opioid prescriptions offered by the nation’s three largest pharmacy benefit plan managers: Optum, CVS Caremark and Express Scripts. Together the three pharmacy benefit plan managers (PBMs) combined control over 90% of the U.S. opioid market. The reforms are aimed at dramatically reducing the number of those at risk of addiction and offering help for those already in addiction’s throes.
U.S. District Court Judge Dan Polster issued the order in response to a September 2018 motion filed in the national opioid litigation by Webb County, Texas and West Virginia-based Teamsters Locals 175 & 505 Health & Welfare Fund. The motion sought leave of Court to file a motion for preliminary injunction directing the PBMs to take immediate steps to align their standard national formularies to the 2016 Centers for Disease Control and Prevention (CDC) guideline to dramatically reduce the escalating distribution and abuse of prescription opioids. Judge Polster denied the motion without prejudice when the parties reached agreement regarding what immediate steps would be required.
“Judge Polster is showing that he means business when it comes to containing the opioid crisis and saving lives. His response is the catalyst for change that is needed to help save lives and we’re proud of our legal team for taking on this fight,” said Teamsters International General Secretary-Treasurer Ken Hall.
Judge Polster’s order focused on the PBMs as the last link in the chain in the opioid crisis. The order aligns the PBMs’ standard national offerings for first-time opioid prescriptions with the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain by memorializing:
Without prior doctor authorization, opioid doses shall be limited to 90 milligrams per day instead of 200 milligrams a day common in the marketplace;
Without prior doctor authorization, prescriptions shall be limited to 7 days instead of extended use that often leads to addiction;
With respect to minors (19 and under), the PBMs either include in their standard national formularies or recommend plans that limit prescriptions to no more than 3 days without doctors’ prior authorization to reduce addiction risk in this vulnerable age group.
Judge Polster’s order also seeks to ease the transition away from addictive opioids by requiring that the PBMs, as part of their standard national offerings, provide for Medication Assisted Treatment (“MAT”) of Opioid Use Disorder and alternatives to opioid products. The order does not interfere with medical decision-making.
Cyrus Mehri of Mehri & Skalet PLLC, lead counsel for the Teamsters Local Nos. 175 & 505 Health and Welfare Fund, explained, “Judge Polster stated at the first hearing in January 2018 that the parties needed to focus less on litigation and more on solutions to address this national crisis. Our clients, led by Teamsters International General Secretary Treasurer Ken Hall, took Judge Polster’s call to action to heart by welcoming the opportunity to join this innovative solution that will save lives. We will hold the PBMs accountable to the letter and spirit of Judge Polster’s order.”
The Teamsters’ focus on stemming the rising tide of the Opioid crisis began at the Teamsters’ 29th International Convention in 2016, where a Teamster official from Ohio shared the tragic story of losing his son — a talented high school athlete — to a heroin overdose after he became addicted to the painkillers he was prescribed following a routine surgery.
Drug overdoses are now the leading cause of death for Americans under the age of 50, and 134 Americans are dying on a daily basis because of the opioid epidemic. The number of Americans who died of drug overdose in 2017 was roughly equal to the number of Americans who died in the Vietnam, Iraq, and Afghanistan wars combined. According to the CDC, the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement due to opioid misuse alone is $78.5 billion a year.
Teamsters Local Nos. 175 & 505 Health & Welfare Fund and Employer Teamsters Local Nos. 175 & 505 Retiree Health & Welfare Fund are represented Mehri & Skalet, based in Washington DC., Henrichsen Siegel, with offices in Washington DC and Jacksonville, Florida, Ciccarello, Del Guidice &LaFon, in Charleston, West Virginia, and Jacksonville, Florida-based Terrell Hogan. Webb County is represented by the Cicala Law Firm LLC, based in Dripping Springs, Texas and Sanford Heisler Sharp LLP, with offices in Washington DC, Nashville, and New York.
Founded in 1903, the International Brotherhood of Teamsters represents 1.4 million hardworking men and women throughout the United States, Canada and Puerto Rico. Visit www.teamster.org for more information. Follow us on Twitter @Teamsters and “like” us on Facebook atwww.facebook.com/teamsters.