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Express Scripts and CVS Health sue to block Arkansas PBM law

The lawsuits argue that the law, scheduled to take effect in 2026, is unconstitutional under multiple provisions.

Photo by Tingey Injury Law Firm / Unsplash

LITTLE ROCK, Ark. — Express Scripts, a Cigna-owned pharmacy benefit manager, and CVS Health have filed separate lawsuits against the state of Arkansas, seeking to halt the implementation of a new law that would bar PBMs from owning, managing, or controlling pharmacies within the state.

In a statement, CVS Health said the “unconstitutional law puts local politics ahead of patients, restricting their access to life-saving medications and undermining fair competition.“

The lawsuits, filed Thursday in the U.S. District Court for the Eastern District of Arkansas, argue that the law, scheduled to take effect in 2026, is unconstitutional under multiple provisions, according to Modern Healthcare. Both companies claim the legislation would lead to significant disruptions in pharmacy access, workforce displacement, and increased medication costs.

CVS Health, which operates numerous pharmacy locations through CVS Pharmacy and affiliated entities, said in a statement that the law would force the closure of 23 stores in Arkansas. Express Scripts, part of Evernorth Health under Cigna Group, warned the law could leave over 600 Arkansans unemployed and contribute to expanding pharmacy deserts in rural areas.

CVS issues response to Arkansas PBM law
“HB1150 is bad policy that accomplishes just the opposite. It will take away access to pharmacy care in local communities, hike prescription drug spending across the state by millions of dollars each year and cost hundreds of Arkansans their jobs.”

The companies also voiced concern over the law’s implications for Medicare Advantage and Part D plans, citing potential confusion for beneficiaries and threats to service continuity. Both lawsuits allege that the law would ultimately result in “higher-cost, lower-quality medications” for consumers.

This legal challenge comes as scrutiny of PBMs intensifies nationwide. In July, the Federal Trade Commission launched an investigation into PBMs' role in inflating drug prices. The FTC later filed a lawsuit accusing Express Scripts, CVS Caremark, and UnitedHealth’s OptumRx of overcharging for insulin—allegations the PBMs have denied and are countersuing in response.

While the federal debate continues, Arkansas is among several states pushing ahead with regulatory action. Supporters of PBM reforms argue that breaking up vertically integrated PBMs could help lower drug costs and improve access, though the industry insists such measures would have the opposite effect.

CVS Health statement on the lawsuit

On May 29, 2025, CVS Health® filed a lawsuit to block Arkansas Act 624, a harmful law that will shut down 23 CVS Pharmacy® locations, eliminate hundreds of jobs and drive-up costs for Arkansans. This unconstitutional law puts local politics ahead of patients, restricting their access to life-saving medications and undermining fair competition.

The issues

Act 624 is designed to target CVS Health, not to protect patients. Arkansas lawmakers crafted the law to exclude CVS Health’s pharmacy operations while protecting in-state pharmacy businesses, which often charge higher prices. There is no way around the fact that Act 624 will limit patients’ options and increase the cost of their medicines.

For these reasons, Act 624 violates the Constitution’s Dormant Commerce Clause, which prevents states from discriminating against or unfairly burdening out-of-state business. Act 624 also is unlawful because it violates Equal Protection rights and is preempted by federal law. We have a right and responsibility to challenge this harmful policy to protect patient care and fair competition.

The facts

Our 23 CVS Pharmacy locations in Arkansas are currently open and will continue to operate for the immediate future. We have not announced any plans to close stores at this time and we’re evaluating any and all options we may have to keep our pharmacies open, including through this legal action.

With Act 624 signed into law, the Arkansas legislature and governor are forcing 23 community pharmacies to close by January 1, 2026, including some of the very few that are open 24 hours; fire more than 500 local health care workers; erode access to specialized pharmacy care for the 10,000 Arkansas patients with serious conditions who rely on additional support; and increase the cost of Arkansas health benefits by millions of dollars each year.

Facts should matter more than rhetoric, and a simple economic analysis could have avoided all this chaos. Factoring in both closures AND openings, there are 14 more independent pharmacies operating in Arkansas today than there were in 2019, and CVS Caremark® reimburses independent pharmacies in Arkansas more than it does CVS pharmacies. Small businesses, employers, health plans and others are going to have to pay more for prescription drugs starting next year because of this new law.

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