Supreme Court Deals Surprise Blow to PBMs in Rutledge Ruling

In a unanimous, earlier-than-expected decision that surprised some observers, the U.S. Supreme Court on Dec. 10 unanimously rejected a trade group’s challenge to a 2015 Arkansas law regulating PBMs. The rule paves the way for states to continue tightening the reins on the increasingly scrutinized “middlemen” in the prescription drug supply chain, provided that such measures involve rate regulation.

The managed care industry had been closely watching the case, Rutledge v. Pharmaceutical Care Management Association (PCMA). That’s because it has implications for not only Arkansas’ Act 900 — which requires PBMs to reimburse pharmacies at no less than what pharmacies pay to acquire drugs — but also a host of other PBM-targeting measures passed by states across the country.

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