UnitedHealth's OptumRx Settles Opioid Prescription Claims for $20M

OptumRx, a pharmacy benefit manager unit of UnitedHealth Group UNH, has reportedly agreed to a $20 million settlement following U.S. government claims that it improperly filled certain opioid prescriptions.

The settlement marks the first instance of the government reaching an agreement with a pharmacy benefit manager (PBM) over alleged illicit opioid prescriptions.

Also Read: UnitedHealth’s OptumRx Unveils New Transparent Drug Pricing Initiative for 2024.

The U.S. Drug Enforcement Administration (DEA) investigated OptumRx’s practices, revealing that a California mail-order pharmacy operated by OptumRx had filled opioid prescriptions in conjunction with other drugs, such as benzodiazepines and muscle relaxants, between 2013 and 2015.

These combination prescriptions are considered “red flags” for potential illicit trafficking under the federal Controlled Substances Act, and the company failed to investigate these red flags consistently, Reuters highlighted, citing the Justice Department.

OptumRx, along with other PBMs, has also been implicated in extensive litigation related to the U.S. opioid crisis.

PBMs are intermediaries between insurance plans and drug manufacturers to negotiate prescription prices.

While no cases against PBMs have gone to trial, the broader litigation has resulted in nearly $50 billion in settlements between local governments, drugmakers, distributors, and pharmacies.

These settlements address accusations against drugmakers for concealing the risks of opioid drugs and against distributors and pharmacies for ignoring warning signs of abuse.

The opioid crisis has led to over 800,000 deaths from overdoses in the United States from 1999 through 2023, as reported by the U.S. Centers for Disease Control and Prevention.

Recently, the Supreme Court rejected a bankruptcy plan for OxyContin-maker Purdue Pharma that would have allocated billions from the wealthy Sackler family to combat opioid addiction, and the Sacklers would have been shielded from civil lawsuits related to their alleged role in the opioid crisis.

The 5-4 decision marks a victory for a minority of opioid victims who voted against the settlement to continue pressing lawsuits against the Sackler family.

Read Next: Drug Distributing Giant Cardinal Health Will Not Renew OptumRx Distribution Pact, Stock Plunges.

Price Action: UNH shares were trading higher by 0.32% to $488.00 at the last check on Friday.

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