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Committee advances bill limiting pharmacy benefit managers from owning pharmacies, sparking debate over access and competition
Summary
House Bill 1150 would require pharmacy benefit managers (PBMs) that own pharmacies to choose between acting as a PBM or operating pharmacies, a move proponents say will stop anti‑competitive steering and opponents say would disrupt specialty care, mail‑order access and jobs; the committee approved the bill by voice vote after extensive testimony.
Representative Jeremiah Moore introduced House Bill 1150, which would prohibit a pharmacy benefit manager from simultaneously operating as a PBM and operating an affiliated pharmacy in Arkansas unless it divests or chooses one role. Moore said the bill targets what supporters describe as conflicts of interest in vertical integration where PBMs can direct prescriptions to affiliate pharmacies and capture payments. "Pharmacy benefit managers for far too long have been able to reimburse their competitors while they reimburse themselves," Moore said.
The bill drew lengthy testimony from a broad set of stakeholders. Supporters — including independent pharmacists and the Arkansas Pharmacists Association — said PBM‑owned pharmacies can be reimbursed at different rates and that steering and preferential contracting have reduced the viability of independent pharmacies in many communities. John Vincent, CEO of the Arkansas Pharmacists Association, described the bill as giving PBM‑owned chains “the choice of whether they wanna be a PBM or a pharmacy. Pick one or the other.” Representatives for independents urged the committee that thousands of local jobs and pharmacies have closed or are at risk; proponents said the measure would restore fair competition and local access.
Opponents — PBM representatives, national pass‑through PBMs, large employers and national retail chains — said the bill would have serious unintended consequences for patient access, specialty drug distribution and employer costs. Sharon Faust of Navitus Health Solutions, a PBM, warned of disruption to patients who rely on mail‑order or PBM‑affiliated specialty pharmacies: she said research shows declines in medication adherence when patients are forced to switch pharmacies and that many specialty therapies are dispensed by a limited set of accredited specialty pharmacies. Adam Head, CEO of CARTI (a cancer care provider), said specialty oncology care requires integrated clinical pharmacy services and that forcing affiliated specialty pharmacies out of the market could “uncomplicate things for patients” and risk timely access to complex drugs.
Specialty pharmacy providers testified that they deliver services beyond dispensing: on‑call clinical pharmacists, nurse infusion programs, administration equipment and manufacturer patient‑assistance navigation. Accredo, a specialty pharmacy, told the committee that removing PBM‑affiliated specialty pharmacies could force patients to travel to hospitals or infusion centers or lose in‑home nursing and pump services.
Republicans and Democrats on the committee asked detailed operational questions: how the State Board of Pharmacy would implement divestiture rules, whether patients would face coverage gaps, how many pharmacies could be affected, and whether the measure would conflict with contract or commerce protections. Moore said he worked with the Attorney General’s office and other stakeholders about defendability and implementation, and noted an amendment requiring the Board of Pharmacy to publish a public written policy for how divestiture would be handled.
Randy Zook, speaking for business groups, argued the bill is government overreach that would reduce competition and risk jobs, and warned it could force divestitures and layoffs if PBM‑affiliated pharmacies must choose. Industry witnesses said the bill could affect affiliated pharmacies across multiple PBMs and vendors and that large employers that self‑fund health care rely on mail order for cost management.
After more than three hours of testimony for and against the bill, Representative Moore closed and the committee approved the bill by voice vote. Committee members flagged multiple implementation issues for follow‑up: the Board of Pharmacy’s rule process, the number and location of pharmacies that could be affected, and protections to preserve continuity of care for patients currently using PBM‑affiliated specialty or mail‑order services.
