Rutledge Anniversary Spurs Bipartisan Push to Help Patients, End PBM Manipulation


The bipartisan support for ending PBMs’ manipulation flows from the conviction that patients deserve better.

The National Association of Chain Drug Stores (NACDS) on Thursday issued the following statement by Steven C. Anderson, president and CEO:

“It is a two-year anniversary that patients and pharmacies can appreciate. With a unanimous decision on December 10, 2020, the U.S. Supreme Court upheld an Arkansas law that confronts the damaging tactics of prescription-drug middlemen known as pharmacy benefit managers (PBMs). NACDS had submitted an amicus brief in this case, Rutledge, Attorney General of Arkansas v. Pharmaceutical Care Management Association (PCMA).

“This Supreme Court decision is a potential turning point to address what really is ‘pharmacy benefit manipulation’ by middlemen for their own profits. PBMs manipulate drug prices. PBMs manipulate patients’ relationships with their pharmacist. PBMs manipulate patients’ choice of pharmacies. PBMs manipulate patients’ access to the medicines a physician prescribes. PBMs manipulate their dealings with pharmacies in ways that jeopardize their viability.

“Immediately, the Supreme Court’s unanimous decision reinforced laws similar to that of Arkansas in approximately 40 other states. Further, over the past two years since the Rutledge decision, more than 100 new state laws have been enacted to address PBM manipulation. Also of significance, the Eighth Circuit of the U.S. Court of Appeals in November 2021 upheld a North Dakota PBM-regulation law – in a case in which NACDS also submitted an amicus brief.

“More work is needed. Fortunately, bipartisan commitment for PBM reform continues to swell in all levels and branches of government. We see this in the form of further legislation and executive action at the state level. At the federal level, Washington, D.C. observers have identified PBM reform as an issue that could see results in the divided 118th Congress, given the bipartisan and intense support for this issue. The Federal Trade Commission also is conducting a study of the PBM industry, its tactics, and its effects on consumers.

“The bipartisan support for ending PBMs’ manipulation flows from the conviction that patients deserve better. Patients deserve more affordable access to medicines. Patients deserve the best value of care from the pharmacy and pharmacist they choose. Patients deserve to not choose between the necessities of life and their medicines. Patients deserve the discounts that PBM manipulators are pocketing rather than passing to them. Patients deserve accountability from middlemen who interfere with their choice and access to care.

“Sustained purpose and progress are necessary. The PBMs will not quietly let their power to manipulate slip away. At the federal and state levels, the PBMs will seek to roll back reform laws, to stymie the implementation of laws, and to block any further progress. In just one example, NACDS and other pharmacy groups in October 2022 submitted an amicus brief to defend an Oklahoma PBM reform law from yet another PCMA challenge.

“NACDS remains committed to securing solutions at the federal and state levels that improve the health and security of patients and of the pharmacies that serve them. The two-year anniversary of the Supreme Court’s Rutledge decision serves as a checkpoint for meaningful progress, and as an igniter of continued bipartisan resolve.”

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