States Bar Pharmacies From Owning PBMs
Tennessee and Arkansas have enacted laws prohibiting companies from owning both pharmacies and pharmacy benefit managers, with other states poised to follow.
Updated on Nov. 2, 2026 in Healthcare
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Should states bar companies from owning both pharmacies and pharmacy benefit managers?
Tennessee and Arkansas have enacted laws barring companies from owning both pharmacies and pharmacy benefit managers. A number of other red and blue states are poised to crack down on pharmacy conglomerates.
Why it matters
Pharmacy benefit managers negotiate drug prices on behalf of insurance plans, and the laws target vertically integrated firms that control both sides of that process. The shift reflects bipartisan frustration over the cost of living and growing political support for breaking up pharmacy conglomerates.
Drug prices fell nearly 3% in the year ending July 2026, the largest decline in more than half a century. The extraction does not detail how the decline is distributed across drug categories or whether it reflects the new laws.
The players
Bill Lee
Bill Lee is the Republican Governor of Tennessee, who signed the state's law barring companies from owning both pharmacies and pharmacy benefit managers.
Sarah Huckabee Sanders
Sarah Huckabee Sanders is the Republican Governor of Arkansas, who signed the state's law barring companies from owning both pharmacies and pharmacy benefit managers.
Donald Trump
Donald Trump is the current President of the United States, whose populist politics have aligned with Republican support for breaking up pharmacy conglomerates.
The details
Tennessee Governor Bill Lee and Arkansas Governor Sarah Huckabee Sanders signed laws barring companies from owning both pharmacies and pharmacy benefit managers. Republicans have increasingly backed breaking up pharmacy conglomerates, a stance tied to President Donald Trump's populist messaging and consumer frustration over costs.
Timeline
Year ending July 2026: drug prices fell nearly 3%, the largest drop in over half a century.
November 1, 2026: report on the crackdown against pharmacy conglomerates published.
Industry Shift
Tennessee and Arkansas's laws establish a template that other states are poised to follow against vertically integrated pharmacy firms. The potential divestiture of hundreds of CVS stores would test how far these state-level restrictions can reshape the industry.
If the laws spread, customers could see changes in where they fill prescriptions and how drug costs are set by insurance plans. Shoppers should watch whether their pharmacy or insurer changes as conglomerates restructure.
The takeaway
Ownership structures in prescription drugs are becoming a political priority, so consumers should check how their pharmacy and insurer are connected. Price changes often trace back to these corporate relationships.
Further reading
Explore more on Healthcare to see how pharmacy benefit management fits into the wider industry.
Source note: This article includes information reported by POLITICO.
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Should states bar companies from owning both pharmacies and pharmacy benefit managers?
