West Virginia filed a federal lawsuit on December 8 2025 against UnitedHealth Group’s pharmacy benefit manager Optum, alleging that the PBM’s opioid distribution practices contributed to the state’s opioid crisis by oversupplying addictive painkillers to local communities.
The lawsuit claims that Optum’s supply‑chain decisions and pricing strategies led to an excess of opioid prescriptions, exacerbating addiction and overdose rates. It also accuses the PBM of conspiring with drug manufacturers to promote false science about opioid safety, increasing daily dosage limits, penalizing clients for restricting opioid dispensing, and creating programs to bypass prior‑authorization rules.
Optum has responded with a statement to Becker’s, saying the lawsuit misrepresents its longstanding commitment to addressing the public‑health crisis. The company highlighted its proactive programs and support for communities, noting that it has not caused or encouraged opioid abuse.
The suit follows a June 2024 settlement in which OptumRx agreed to pay $20 million to resolve federal claims that it ignored opioid “red flags.” It also follows West Virginia’s earlier August 2025 lawsuit against Express Scripts, and Arkansas’s 2024 lawsuit against both PBMs, placing the case within a broader multidistrict litigation in Ohio.
If the court finds UnitedHealth liable, Optum could face significant financial penalties and be required to implement costly compliance reforms. The lawsuit could also damage the PBM’s reputation, increase regulatory scrutiny, and affect future reimbursement arrangements, prompting investors to reassess UnitedHealth’s risk profile and financial performance.
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