State Capitol building, in Little Rock, Arkansas.
An Arkansas bill prohibiting pharmacies from being owned by pharmacy benefit managers (PBMs) will take effect Jan. 1, 2026. Gov. Sarah Huckabee Sanders signed HB 1550 into law last week, marking the first time a state has banned PBMs from owning pharmacies.
The Arkansas Pharmacists Association (APA), with the support of the National Community Pharmacists Association (NCPA), led the effort to move the bill through the legislative process. NCPA has been involved at the federal level and across states pushing for reforms addressing what it said are conflicts of interest and anticompetitive business practices that arise from the vertical integration of PBMs with health insurers and pharmacies. Such integration restricts competitor access to patients, steers patients away from community pharmacies and raises prescription drug prices, the association said.
Recommended For You
CVS, which is a major player in the PBM market via its CVS Caremark brand, said it may have to close up to 23 stores in Arkansas as a result of the legislation. In a statement provided to Drug Store News, CVS said the law could result in the termination of more than 500 local healthvcare workers, erode access to specialized pharmacy care for 10,000 Arkansas patients with serious conditions, and increase the cost of health benefits in the state by millions of dollars every year.
Further, the company said there are 14 more independent pharmacies operating in Arkansas today than there were in 2019, and CVS Caremark reimburses independent pharmacies in Arkansas 61% higher than it does CVS pharmacies.
Similar ownership provisions are under consideration in Indiana, New York, Texas and Vermont. At the national level, a bipartisan bill was introduced last year called the Patients Before Monopolies Act that would prohibit joint ownership of PBMs and pharmacies.
A coalition of 39 state and territory attorneys general recently sent a letter to congressional leaders urging them to pass legislation prohibiting PBMs from owning or operating pharmacies. The letter noted PBMs were created in the late 1960s to process claims for drug companies and were meant to help consumers access low-cost pharmaceutical care through negotiated volume-pricing discounts, generic substitution, manufacturer rebates and other tools.
“While the promise of PBMs was to lower health care costs, the reality has been the opposite: health care costs in the United States have skyrocketed,” the letter said. “PBMs are using manufacturer rebates to increase, rather than decrease, drug prices. Health care costs are higher in the United States than any other developed country in the world, but health care outcomes in the United States are not equally extraordinary.”
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Kristen Smithberg
Kristen Smithberg is a Colorado-based freelance writer who covers commercial real estate, insurance, benefits and retirement topics for BenefitsPRO and other industry publications.
