Supreme Court declines to review Oklahoma law regulating PBMs

The U.S. Supreme Court has declined to review an appeals court ruling that struck down key parts of an Oklahoma law regulating the retail networks created by pharmacy benefit managers, a victory for the controversial middlemen in the pharmaceutical supply chain that may create uncertainty across the country.

The law, which was enacted in 2019, was designed to ensure that pharmacy benefit managers maintain access to a large number of pharmacies and do not steer patients to favored outlets, among other things. The move came amid increased concern that opaque business practices were raising prescription drug costs for consumers and health plans, often by squeezing independently owned pharmacies.

But the Pharmaceutical Care Management Association, a trade group for pharmacy benefit managers, sued to block the law and objected to Oklahoma’s attempt to “interfere” with efforts to administer health plans that promote “affordable choices” for patients. Specifically, the group argued the law was preempted under the Employee Retirement Income Security Act and the Medicare Part D program.