Little Rock, Arkansas – Arkansas is locked in a high-stakes legal battle with some of the nation’s largest pharmacy benefit managers (PBMs) over a state law that could reshape how prescription drugs are sold in the state. The law, known as Act 624, would prohibit PBMs from owning pharmacies in Arkansas, a move that supporters say is critical to protecting patients and independent pharmacies alike.
Critics, including the Federal Trade Commission, argue that PBMs wield excessive power over drug pricing. Independent pharmacies claim they are often underpaid while PBMs overpay for prescriptions in their own pharmacies, steering patients toward their locations and inflating costs in the process. The FTC highlighted one startling example in a recent report: a cancer drug sold for more than $19,000 by a PBM, while the same medication cost just $97 at a Walgreens pharmacy.
Major PBMs, including Express Scripts, CVS, and OptumRx, along with their trade group, have filed lawsuits against Arkansas, claiming that Act 624 would interfere with interstate commerce. A federal judge has temporarily blocked the law from taking effect on January 1, prompting the state to appeal to the Eighth Circuit.
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Despite these challenges, Arkansas has strong backing from organizations representing local pharmacies. The Arkansas Pharmacists Association, the National Community Pharmacists Association, and the Community Oncology Alliance have all filed briefs supporting the state’s position. Additionally, the Arkansas Farm Association has submitted legal briefings as a friend of the court, highlighting the broad coalition advocating for the law.
Supporters of Act 624 argue that the legislation could save lives by giving patients more reliable options for filling prescriptions. Vincent, a vocal supporter of the law, emphasized its urgency: “It is literally a matter of life and death.” The Community Oncology Alliance shared a troubling case where a cancer patient’s treatment was delayed because a PBM required the medication to be filled through its mail-order pharmacy, allowing the disease to progress.
If Act 624 ultimately takes effect, PBMs would be required to close or divest their pharmacies in Arkansas, a step supporters believe would level the playing field for independent pharmacies and improve access for patients. Proponents argue that without such measures, patients may continue to face inflated drug prices and restricted pharmacy choices.
State officials maintain that their appeal is not just about business interests, but about patient safety and fairness in the healthcare system. “Act 624 aims to give patients more options and protect the integrity of community pharmacies,” a state spokesperson said. “Our focus is on ensuring that Arkansans have access to affordable medications and timely care.”
The case has captured national attention as it raises broader questions about the influence of PBMs on the healthcare system. How the courts rule could have ripple effects across the country, affecting pharmacy operations, drug pricing, and patient access to medications. For Arkansas, the outcome of this battle may determine whether local pharmacies can compete fairly and whether patients receive the care and options they need.
