pharmacy Benefit Managers Face legal Challenges Over Pharmacy Ownership, retail Networks

⁤ ‍ Updated May 30, 2025

Pharmacy benefit managers⁤ (PBMs) ⁤are facing increased scrutiny and legal challenges regarding their business practices. ⁤Recent developments include a recommendation from the U.S. solicitor general concerning an Oklahoma ‍law and lawsuits⁤ filed by CVS and Express Scripts against an⁢ Arkansas law.

The solicitor general has advised the Supreme Court not to review an appeals court decision that struck down key provisions of an Oklahoma law regulating PBM retail networks. The‍ 2019 law aimed to ensure broad pharmacy access and prevent PBMs from steering patients to preferred pharmacies. However, a PBM trade group challenged the law, and an appeals court ruled that federal law preempted it.⁢ Oklahoma Insurance Commissioner Glen Mulready sought Supreme Court review, but the solicitor ⁤general sided with‍ the appeals court on three challenged provisions.

Simultaneously occurring, CVS and Express Scripts have initiated separate lawsuits to challenge an Arkansas law set to take effect⁢ next year.This law would prohibit pharmacy benefit managers from owning pharmacies.⁣ The companies argue that ⁣the law ‍unconstitutionally restricts interstate⁢ commerce ⁣by burdening out-of-state entities. Both companies are seeking a declaration that the law is unconstitutional and an injunction against its enforcement.

The Arkansas law, the first of ‍its kind in the ⁣nation, seeks to prevent conflicts of interest by ⁣barring PBMs from operating both retail‍ and mail-order pharmacies. Supporters say this will address concerns that large pbms,⁣ controlled by CVS Health, Cigna, and UnitedHealth Group, favor their own pharmacy operations, thereby distorting drug distribution and pricing.

What’s next

The legal battles in Oklahoma⁣ and Arkansas could set precedents for how states regulate pharmacy benefit managers and address concerns about their impact on⁣ drug prices and ⁣pharmacy access. The outcomes of these cases will likely influence future legislation and regulation in the pharmaceutical industry.