Express Scripts and the Pharmaceutical Care Management Association (PCMA) have filed a lawsuit in federal court seeking to block the FAIR Rx Act, a Tennessee law passed earlier this year over strong opposition from pharmacy benefit managers. The legal action targets provisions that would require PBMs to divest their pharmacy ownership interests within the state.
The complaint follows a similar challenge brought by CVS Caremark, alleging the law violates federal regulations and could disrupt prescription drug access for millions of patients. The FAIR Rx Act was designed to address conflicts of interest where PBMs both manage drug benefits and operate their own pharmacies.
PCMA argues the law exceeds state authority and conflicts with federal rules governing employer-sponsored health plans governed by ERISA. The group contends the legislation would increase costs and reduce competition, contrary to its stated goals of lowering drug prices.
Tennessee lawmakers who backed the measure say it is necessary to curb anticompetitive practices that drive up costs for patients and independent pharmacies. The FAIR Rx Act mirrors similar efforts in other states targeting the vertical integration of PBMs with pharmacy chains.
The case now moves to federal court, where judges will weigh state consumer protection interests against federal preemption claims advanced by the PBM industry. Oral arguments have not yet been scheduled.