Pharmacy Benefit Managers Implement Critical Changes to Nationwide Practices That Promote Safe Opioid Prescribing Following Injunction Motion Filed in Opioid Litigation

Posted July 15th, 2019.

Click here to read the injunction 

Cleveland, July 15, 2019 – U.S. District Judge Dan Polster, who oversees the National Prescription Opiate Litigation, entered an order confirming that the three largest Pharmacy Benefit Managers (PBMs) in the country have implemented and/or will implement changes to their standard nationwide practices that align with the Center for Disease Control’s (CDC) Guideline for Prescribing Opioids for Chronic Pain.  Judge Polster’s order follows a motion conceived of by Webb County Texas and filed against PBMs Caremark, Express Scripts, and OptumRx in September 2019.  Webb County recognized that several of the PBMs’ standard national offerings were not consistent with CDC Guidelines the PBMs had embraced as representing appropriate standards of care.  Webb County further recognized Judge Polster’s priority to abate the flow of unnecessary opioids into communities nationwide. Webb County filed its motion, which was joined by Employer-Teamsters Local Nos. 175 & 505 Health & Welfare Fund, and Employer Teamsters Local Nos. 175 & 505 Retiree Health & Welfare Fund to provide the Court with a vehicle to achieve its objectives.  Judge Polster denied the motion for leave without prejudice when the parties reached agreement regarding what immediate steps would be and are required.

Judge Polster’s Order (attached), identified critical steps taken by PBMs since the injunction was filed or to be implemented by October 1, 2019 to promote restrictions on the strength and supply of opioid drugs made available to patients, the availability of medication assistance treatment drugs and heightened restrictions on opioid prescriptions for minors.

“Judge Polster’s order is a constructive step towards saving lives and abating the opioid crisis.  And, critically, the order does not interfere with medical decision-making,” said Joanne Cicala of The Cicala Firm PLLC, lead counsel to Webb County. “Webb recognized the opportunity to make contact with the Court’s objectives through this motion, which sought necessary and overdue corrections to the PBM national formularies.”  Webb County was the first litigant in the Country to recognize the central role PBMs have played in fueling the opioid epidemic, together with opioid manufacturers, distributors and retailers.

“We ignore the role of PBMs in the opioid epidemic at our peril,” added Kevin Sharp of Sanford Heisler Sharp, Webb County co-counsel.  “As counties have described in complaints filed in courts across the nation, PBMs function as gatekeepers whose actions influence which patients are prescribed opioid drugs, what drugs are dispensed, at what dosage, and in what supply.  Judge Polster’s Order acknowledging PBMs’ ability to impact opioid abuse on a national scale powerfully corroborates our clients’ view of PBM’s role in the epidemic.”

Webb County is represented by The Cicala Law Firm PLLC, based in Dripping Springs Texas.  Sanford Heisler Sharp is co-counsel to The Cicala Law Firm.

About The Cicala Law Firm PLLC

The Cicala Law Firm PLLC is a plaintiff’s civil litigation firm with particular expertise in prosecuting commercial, consumer and health care fraud matters on behalf of individuals, businesses and governmental clients. It maintains a diverse, experienced and nimble team comprised of attorneys, analysts, health care and IT professionals. The firm is committed to taking advantage of cutting-edge technology to identity claims and particularize damages, including through data mining. The firm has the ability to do this work in-house which permits substantial cost savings for its clients. In addition to its litigation and big data services, The Cicala Law Firm is available for health care cost containment efforts such as pharmacy benefit claims evaluation. It welcomes strategic partnerships with other firms where its competencies may complement those of the collaborating firm.

For more information go to or call (512) 275-6550 or email

About Sanford Heisler Sharp

Sanford Heisler Sharp is a public interest class-action litigation law firm with offices in New York; Washington, D.C; San Francisco; Nashville; San Diego; and Baltimore.  Our attorneys have graduated from the nation’s top law schools, clerked for judges throughout the United States, and amassed extensive experience litigating and trying cases that have earned over one billion dollars for our clients.

The Firm specializes in civil rights and general public interest cases, representing plaintiffs with claims of employment discrimination, sexual violence, labor and wage violations, predatory lending, consumer fraud, and whistleblowing, among other claims. Along with a focus on class actions, the Firm also represents individuals and has achieved extraordinary success in the representation of executives and attorneys in employment disputes.

For more information go to or call (646) 681-7373 or email For the latest news, visit our newsroom or follow us on Twitter at @sanfordheisler.