Express Scripts sues Arkansas over new PBM law

Express Scripts by Evernorth, the pharmacy benefits business of The Cigna Group, and its affiliated pharmacies, filed a lawsuit Thursday (May 29) in federal court to strike down Arkansas’ new law regarding PBMs (pharmacy benefit managers).

Calling the law “misguided,” the lawsuit claims the new act passed by the Legislature will “reduce access to health care and prescription medicines for hundreds of thousands of Arkansans” and “violates the U.S. Constitution and is unenforceable.”

The suit was filed in the U.S. District Court for the Eastern District of Arkansas. The suit was filed on behalf of Express by Washington, D.C.-based WilmerHale, a global law firm, and Little Rock-based Mitchell, Williams, Selig, Gates & Woodyard.

The law, Act 624, restricts companies that own PBMs from owning pharmacies in Arkansas starting Jan. 1, 2026.

“Our family of pharmacies — including Express Scripts Pharmacy, Accredo Specialty Pharmacy, and Freedom Fertility Pharmacy — are proud to serve Arkansans, and this law will disrupt their access to the care we provide,” said Susan Peppers, RPh, vice president of Pharmacy Practice, Evernorth Health Services. “If this law takes effect in January, hundreds of thousands of Arkansans will be left scrambling to navigate the forced closure of pharmacies and finding new ways to get their medicines and critical clinical support. Our Arkansas patients deserve convenient access to care and affordable medicines, and we are doing everything we can to protect that for them.”

Express Scripts claims Act 624 will not lower health care costs, but instead force some prescription drug benefits to increase. It also contends the pharmacy market will shrink from closures.

The lawsuit requests preliminary and permanent injunctive relief for Express Scripts and claims the Arkansas law violates the U.S. Constitution’s Commerce Clause, Privileges and Immunities Clause, and Article 1, Section 10 of the Bill of Attainder Clause.

The company said last year Express Scripts mailed more than 700,000 prescriptions to Arkansans and that as many as 40% of rural citizens could be negatively impacted by the change.

“Arkansas politicians are gambling with the health and well-being of Arkansans who depend on the medicines and services they receive from Evernorth pharmacies,” said Andrea Nelson, chief legal officer, The Cigna Group. “While Arkansas politicians claim this law was designed to lower drug prices and increase access to medications, it will do just the opposite. This law will have devastating consequences for Arkansans’ access to essential medications, and we cannot allow it to stand, which is why we are taking legal action today.”

You can read a copy of the Express Scripts lawsuit here.

UPDATE: Later in the day, CVS, which has pharmacies and is a PBM, filed a lawsuit to stop Act 624.

“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,” the company said in a press release.

You can read the CVS lawsuit here.

Attorney General Tim Griffin offered a response to the legal filings.

“Pharmacy benefit managers wield outsized power to reap massive profits at the expense of consumers. The rise of PBMs as middlemen in the prescription drug market has resulted in patients facing fewer choices, lower quality care, and higher prices. PBMs leverage their affiliated pharmacies to manipulate prices, corrupt the market, and destroy competition. Through Act 624, Arkansas is standing up to PBMs on behalf of consumers, and I will vigorously defend our law,” said Griffin.