Community Oncology Alliance Files Amicus Brief Supporting Arkansas Law Regulating Pharmacy Benefit Managers

COA Backs State Efforts to Curb PBM Conflicts of Interest and Protect Patient Access to Local, Affordable Cancer Care

WASHINGTON, DC, UNITED STATES, November 3, 2025 /EINPresswire.com/ -- The Community Oncology Alliance (COA) has filed an amicus curiae brief with the United States Court of Appeals for the Eighth Circuit in support of Arkansas Act 624, the state’s new law banning pharmacy benefit managers (PBMs) from owning or controlling pharmacies. COA’s brief provides firsthand evidence of how PBM vertical integration – when PBMs own the very pharmacies they direct patients to use – harms patients, drives up costs, and undermines access to timely care.

“Arkansas is leading the way in addressing one of the most damaging conflicts of interest in the health care system, PBM pharmacy ownership,” said Ted Okon, executive director of COA. “When PBMs act as both gatekeepers and competitors, patients suffer from treatment delays, medication errors, and inflated costs. Arkansas’ Act 624 restores fairness and accountability – and we believe other states should follow its example.”

Act 624, enacted earlier this year, prohibits PBMs from owning or operating pharmacies within Arkansas. Its intent is to end the self-dealing that occurs when PBMs steer patients to their own mail-order or specialty pharmacies instead of allowing them to receive medications from trusted local providers. COA’s filing supports Arkansas’ appeal of a lower court ruling that temporarily blocked enforcement of Act 624 following a lawsuit from PBM lobby groups.

Patient PBM Horror Stories Illustrate the Stakes

COA’s amicus brief highlights real-world examples from community oncology practices in Arkansas that show how PBM ownership of pharmacies directly harms patients. A shocking but common example includes week-long treatment delays for brain cancer medication because a PBM required the medication to be filled through its own mail-order pharmacy rather than the local oncology practice that could dispense it immediately. In another horror story, patients taking common oral chemotherapy drugs were forced to pay hundreds of dollars more in copayments when PBMs denied coverage at the local independent pharmacies.

“PBM horror stories aren’t bureaucratic hiccups – they are life-threatening barriers to care,” said Okon. “Community oncology practices see every day how PBM control over pharmacies disrupts treatment and hurts patients. Act 624 is a model for fixing that.”

COA has compiled eight volumes of patient horror stories exposing the abuses of PBMs. These are featured on www.PBMAbuses.com, which seeks to highlight the patient impact of PBM misbehavior.

Arkansas Act 624 Has National PBM Reform Implications

COA’s brief also outlines the broader national impact of PBM consolidation and vertical integration, drawing on findings from the Federal Trade Commission, the Government Accountability Office, and Congress. With just three PBMs – CVS Caremark, Express Scripts, and OptumRx – now controlling more than 80 percent of the prescription drug market, conflicts of interest have become systemic. The Arkansas reform effort, COA argues, is an important state-level corrective that other states can emulate.

“Arkansas is ground zero in the fight for fair pharmacy regulation,” said Okon. “If this law is upheld and implemented, it will serve as a blueprint for states seeking to protect patients and restore balance to an industry dominated by unregulated middlemen.”

Read the full COA Amicus Brief in Arkansas PBM Regulation at https://mycoa.communityoncology.org/publications/comment-letters/coa-amicus-brief-in-arkansas-pbm-regulation

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About the Community Oncology Alliance (COA)
The Community Oncology Alliance (COA) is a nonprofit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology, where the majority of Americans with cancer are treated. The mission of COA is to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities. Learn more at www.communityoncology.org.

Drew Lovejoy
Community Oncology Alliance
info@coacancer.org

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