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In 2020, the U.S. Supreme Court unanimously agreed with the arguments in a California-led, bipartisan amicus brief filed by 46 attorneys general, which supported the state of Arkansas’ position that federal law does not prevent states from regulating Pharmacy Benefit Managers PBMs.

Last year California joined a coalition of 34 attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Eighth Circuit supporting North Dakota’s regulation of PBMs.

And on October 18, 2022 the California Attorney General announced joining a coalition of 35 attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Tenth Circuit in support of Oklahoma’s authority to regulate Pharmacy Benefit Managers.

PBMs act as a middleman between pharmacies, drug manufacturers, health insurance plans, and consumers. This position allows them to have a significant impact on consumers’ access to affordable prescription drugs.Over the years, PBMs have expanded into a multi-billion dollar industry.

The California Attorney General claims they have done “nothing to lower the prescription drug prices paid by health plans to drug manufacturers. In response, states like California have increased their regulation of PBMs to protect residents from the rising cost of prescription medications. This regulation is essential because the price consumers pay for pharmaceuticals has continually risen under the oversight of PBMs.”

“Prescription drug spending in the United States has increased year after year. In 2021, the U.S.’s total drug spending grew by 7.7% to $576.9 billion, and it is projected to continue increasing and comprising more of the country’s gross domestic product. Running parallel to this massive increase, the role of PBMs in the industry has expanded over the past 50 years, and PBMs now control nearly every aspect of a health plan’s pharmacy benefits”

The Coalition of 35 attorneys general have filed their amicus brief in the Oklahoma case of Pharmaceutical Care Management Association v Glen Mulready et al., pending in the United States Court of Appeals for the 10th Circuit.

In 2019, the Oklahoma Legislature passed the Patient’s Right to Pharmacy Choice Act to protect Oklahomans’ access to pharmacy providers and protect pharmacies from self-serving practices of PBMs. The new law was soon challenged in court by the Pharmaceutical Care Management Association (PCMA, the PBMs’ trade lobby).

In early April, the U.S. District Court for the Western District of Oklahoma ruled largely in favor of the State of Oklahoma and Insurance Commissioner Glen Mulready in PCMA v. Mulready, upholding most of the Oklahoma statute against a federal preemption challenge.

PCMA appealed that decision to the U.S. Court of Appeals for the Tenth Circuit, asserting that only four of the provisions are preempted by ERISA and Medicare Part D, retreating from the 14 it originally had challenged.

The National Community Pharmacists Association (NCPA), the American Pharmacists Association (APhA) and the National Association of Chain Drug Stores (NACDS), along with American Pharmacies (APRx) and the Oklahoma Pharmacists Association (OPhA), also filed an amicus curiae brief defending states’ rights of Oklahoma to pass and enforce laws protecting patients and community pharmacies from predatory pharmacy benefit manager (PBM) practices.