Arkansas at Center of National Battle Over Pharmacy Benefit Managers

Arkansas is taking center stage in a growing national debate between local pharmacies and powerful corporations known as Pharmacy Benefit Managers (PBMs)—companies that act as intermediaries in the prescription drug industry.

Local pharmacists accuse PBMs of anti-competitive practices that have forced more than 60 local pharmacies to close since 2016. In response, the Arkansas legislature has passed House Bill 1150, which would prohibit PBMs from operating retail or mail-order pharmacies in the state.

Supporters of the bill say it will help level the playing field and protect small businesses. A Senate co-sponsor acknowledged concerns about potential job losses if PBMs close their operations but pointed out that many Arkansans have already lost jobs due to pharmacy closures caused by PBM practices.

The Senate approved HB 1150 by a vote of 26-9 and the House by 89-4. It now heads to the governor’s desk.

A PBM spokesman warned that if the bill becomes law, the company will close its 23 Arkansas locations, impacting dozens of employees who testified emotionally before lawmakers.

National attention is growing, as other states may follow Arkansas’ lead if HB 1150 becomes law. The Federal Trade Commission notes that just three PBMs currently control pricing for 80% of U.S. prescriptions.

In related action, the Arkansas Senate also passed HB 1531, which would prohibit drug manufacturers from limiting distribution to out-of-state mail-order pharmacies—another move aimed at protecting access to medications through local pharmacies and clinics.