In Arkansas, families struggle daily with the high cost of prescription medications. With household budgets tighter than ever, affordable access to needed drugs is a lifeline. Recent headlines have focused on legal battles over Pharmacy Benefit Managers (PBMs) and a new state law banning PBMs from owning pharmacies. While a recent court decision may seem to be a setback, it actually offers Arkansas a unique opportunity to preserve drug affordability and ensure access for families across the state.
Act 624, which would have barred PBMs from owning pharmacies in Arkansas, was put on hold by a federal court. While the motivation for the law was to address conflicts of interest and support independent pharmacies, national analysis reveals such a ban could have forced major pharmacy chains to shutter their locations in Arkansas, eliminating many of the state’s 24-hour pharmacies and disrupting care for tens of thousands, especially in rural areas. Specialty pharmacy access for patients with complex conditions, such as severe mental illness or autoimmune disorders, would have been threatened, as these patients often depend on mail-order or specialty services provided through PBMs.
Arkansas employers and families would not only see pharmacies closing, but they could also face higher prices for their prescription drugs. When PBM operations bifurcate from pharmacy ownership, the efficiency and negotiating power that drive down drug prices are weakened, and costs shift back to consumers and employers. In other words, rather than curbing Big Pharma, the legislation risked increasing the exact pressures it sought to relieve.
PBMs administer benefit plans for nearly 290 million Americans, negotiating rebates and discounts to keep generic and brand drug prices in check. In Arkansas—where rural communities already have limited pharmacy options—PBM-run mail order and 24-hour pharmacies are sometimes the only accessible resource for families managing chronic conditions or living far from the nearest town center. Breaking apart PBMs’ relationships with pharmacies could have crippled home delivery programs, severed specialty care for thousands, and forced families to travel much farther for vital medications.
Rather than upending the current system in ways that harm access and raise costs, Arkansas should seize this moment to enact reforms that work for everyone. This includes enhancing transparency, ensuring rebate savings flow back to patients and payers. It also includes protecting rural access by mandating robust pharmacy networks that include independent and community locations. We also should reward value, not just volume, through outcome-based contracts. IN addition, we should empower state employee and Medicaid plans to negotiate net savings that benefit Arkansas families directly.
When these reforms are properly implemented, PBMs act as diligent overseers that deliver real savings—helping Arkansans save more than $1,150 per year on average, lowering rates of costly hospital admissions, and enabling the entire state workforce to better afford coverage.
The federal court’s injunction is a chance for Arkansas to pursue the kind of smart reform that brings relief, not disruption, to patients. State policymakers should now focus on constructive changes that preserve drug access, empower rural providers, and demand accountability from PBMs. Moving forward, let’s elevate solutions that protect Arkansas families, because the real challenge isn’t whether PBMs can own pharmacies, but whether every Arkansan can afford and receive the medications they need when they need them.
Access, affordability, and accountability are not mutually exclusive. By embracing evidence-based reforms and learning from this legal experience, Arkansas can lead the way in delivering real drug savings for all its families.
Julia Pierce is committee chair for the Dallas County Republican Party and is involved in business development for the Metroplex Civic and Business Association.