8th Circuit Reviews Arkansas Pharmacy Law
The appellate court is evaluating a challenge to a 2025 state law that restricts pharmacy benefit managers.
Updated on Oct. 20, 2026 in Healthcare
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The 8th Circuit Court of Appeals held a hearing in September 2026 to determine the legality of Arkansas Act 624. The law, which bans pharmacy benefit managers from owning pharmacies, currently faces a federal preliminary injunction.
Why it matters
Arkansas enacted the legislation to address conflicts of interest and protect local pharmacy operations. Industry groups argue the ban unconstitutionally interferes with interstate commerce.
A Federal Trade Commission report highlighted a pharmacy benefit manager selling a cancer drug for over $19,000, while the same medication costs $97 at Walgreens. These companies are responsible for setting drug reimbursement rates for insurance.
The players
8th Circuit Court of Appeals
This federal appellate court hears appeals from district courts within its circuit, which includes Arkansas.
CVS Caremark
This entity is a major pharmacy benefit manager that manages prescription drug benefits for health plans.
Express Scripts
This is a large pharmacy benefit management organization that provides integrated pharmacy services.
OptumRx
This company functions as a pharmacy benefit manager and is a subsidiary of UnitedHealth Group.
Federal Trade Commission
This independent agency of the United States government promotes consumer protection and competition.
The details
Arkansas passed Act 624 in 2025 to mitigate concerns that pharmacy benefit managers underpay independent pharmacies while overpaying their own subsidiaries. Companies including CVS Caremark, Express Scripts, and OptumRx sued to block the measure, leading a federal judge to issue an injunction.
Timeline
Arkansas passed Act 624 in 2025.
The 8th Circuit Court of Appeals held a hearing in September 2026.
Market Landscape
This dispute over Act 624 represents a significant effort by states to curb the influence of pharmacy benefit managers in the drug supply chain. It highlights an ongoing competitive struggle between large PBMs and independent pharmacy networks over control of reimbursement rates.
The legal outcome will determine if independent pharmacies in Arkansas can operate without the current ownership structures of major pharmacy benefit managers. Residents may see changes in how drug reimbursement rates are set and how their local pharmacies interact with insurance plans.
The takeaway
The appellate proceedings reflect the growing tension between state legislative oversight and national pharmacy benefit management business models. Readers should monitor future court decisions as they will likely influence the cost and access of prescription drugs across the state.
Further reading
For broader updates on regional medical regulations, visit the Arkansas Healthcare page.
Source note: This article includes information reported by KATV.
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