US Supreme Court Declines to Hear Challenge to Arkansas’ Regulation of 340B Program

The U.S. Supreme Court on Monday declined to hear a challenge to Arkansas’ 340B Drug Pricing Nondiscrimination Act, leaving in place a March 12 ruling by the U.S. Court of Appeals for the Eighth Circuit that upheld the state law.

The Pharmaceutical Research & Manufacturers of America (PhRMA) had sought to overturn that decision, stating federal law preempted Arkansas’ legislation.

The Supreme Court’s denial marks the end of a lengthy legal battle over the act. The law, passed in 2021 as Act 1103, prevents pharmaceutical manufacturers from restricting health care providers’ ability to use local pharmacies for distributing federal 340B-discounted medications. Attorney General Tim Griffin said in a news release following the Supreme Court’s decision that the law “fills a gap in federal law that manufacturers previously exploited to deny equal drug access to rural patients.”

“This is a big win for Arkansas’s drug access law,” Griffin said in the release. “With the United States Supreme Court refusing this appeal, the Eighth Circuit’s ruling that Act 1103 is not preempted stands.”

The case traces back to 2020, when several pharmaceutical manufacturers began limiting health care providers’ ability to work with local pharmacies to distribute 340B drugs — a move that particularly threatened rural access to affordable medications. The Arkansas General Assembly responded by passing Act 1103, leading to PhRMA’s legal challenge.

“Today’s win means that manufacturers must continue to provide equal access to patients across Arkansas,” Griffin said in the release.

Griffin credited Solicitor General Nicholas Bronni, Senior Assistant Solicitor General Asher Steinberg and the solicitor general team for their work on the case, which has implications beyond Arkansas as other states consider similar legislation to protect the ability to use contract pharmacies in the 340B program.