(Editorial - Graphic Illustration - MetroCreativeConnection)

As West Virginians have waded through the battle against the substance abuse epidemic over the past several years, it has become clear there is fault to find at many levels — from “legal” drug dealers masquerading as doctors to pharmaceutical industry giants. That is, of course, in addition to the illegal drug operations that realized what was happening and seized the moment.

As state attorney general, Gov. Patrick Morrisey did an excellent job battling companies such as Johnson and Johnson, CVS and Kroger — to name a few — in an effort that has yielded hundreds upon hundreds of millions of dollars to be distributed to fight the substance abuse epidemic.

His successor in the attorney general’s office, J.B. McCuskey, is continuing that fight with a lawsuit against the owners of Express Scripts. Pharmacy benefits management company Evernorth Health Inc. is accused of having contributed to the oversupply of prescription opioids in West Virginia by prioritizing profits and leveraging its market dominance. It allegedly conspired with manufacturers, incentivized sales through formulary placements, weakened safety protocols, ignored warning signs and improperly dispensed opioids via mail-order pharmacies.

“Express Scripts played a central and concealed role in enabling the widespread oversupply of opioids through a combination of intentional conduct, strategic partnerships, calculated intention, and action,” McCuskey said. “Express Scripts helped facilitate the unchecked prescribing, dispensing, and sale of opioids in West Virginia. As a key intermediary between drug manufacturers, pharmacies, and insurers, Express Scripts inserted itself directly into the supply chain. In so doing, it assumed legal duties to act responsibly. It did not do so.”

Most people don’t have a good grasp of what a pharmacy benefits management company does, and those companies like it that way, operating in the shadows. Express Scripts was at one time the largest such company.

Utah, Kentucky and Michigan are also suing Express Scripts, a company that, according to a report by the Ohio Capital Journal has no problem disclosing that it “…paid itself more than 100 times as much for the most expensive class of drugs than it could have paid if it had gotten them elsewhere.”

If it was willing to engage in that kind of behavior, McCuskey is right to question its other actions.

While the results of West Virginia’s and the other states’ efforts are yet to be determined in the courts, it is encouraging to know McCuskey and his colleagues are not letting up.