Most litigation against opioid manufacturers has focused on accusations of fraud or misleading marketing that they claim contributed to the addiction crisis, but a new class-action suit holds them responsible for spiraling insurance costs.

Three law firms have filed suits on behalf of federal plaintiffs in New York, New Jersey, Massachusetts, Illinois and California alleging fraudulent marketing practices and negligence in distributing products, but they are the first lawsuits to specifically address the increased insurance costs. Like many of the previous litigation efforts, the lawsuits target major manufacturers such as Janssen and Purdue as well as major distributors such as Cardinal Health and McKesson. The putative class includes anyone who bought an insurance policy in the five states since 1996.

Centers for Disease Control data estimate that opioid abuse drove a $14 billion spike in nationwide private insurance costs in 2013, according to the plaintiffs.