Missouri is being sued over a new law that requires drugmakers to provide discounted prescriptions under the 340B program to any pharmacy contracted with a qualified provider. Three major pharmaceutical companies—Novartis, AstraZeneca, and Abbvie—and their lobbying group, PhRMA, have filed lawsuits to stop this law.
The companies argue that the Missouri law, passed this year, is unconstitutional because it interferes with interstate commerce. The law mandates that drugmakers must deliver medications to providers eligible for discounts under the 340B program. It also allows these providers to contract with an unlimited number of pharmacies to dispense the discounted drugs.
PhRMA’s lawsuit, filed last week, claims that Missouri has no authority to decide who gets access to these discounted drugs under federal law.
The law is set to take effect on Wednesday. The companies have asked for a preliminary injunction to prevent it from being enforced, but no hearings have been scheduled yet. The lawsuits name Missouri Attorney General Andrew Bailey and the state Board of Pharmacy, which would enforce the law.
The Missouri Hospital Association and the Missouri Primary Care Association have asked to join the Novartis lawsuit, saying that the revenue from 340B medications is vital for their operations.
The 340B program, created in 1992, requires drug manufacturers to sell their products at a discount to eligible providers, such as hospitals serving low-income communities. Over time, the use of contract pharmacies has expanded, with the number of these pharmacies growing significantly from 2010 to 2024.
Pharmaceutical companies argue that the program has become more about profit than helping vulnerable patients. They claim that the discounts often don’t reach the patients and are instead shared between the pharmacies and providers. The companies have also fought against the expansion of contract pharmacies, with courts allowing them to limit the number of pharmacies they work with.
Missouri is one of eight states to pass laws requiring drugmakers to deliver discounted medications to contract pharmacies. The Missouri attorney general’s office is relying on a court ruling from Arkansas, which upheld a similar law, to support their case.
The pharmaceutical companies are using various legal arguments to challenge the Missouri law, including claims that it violates property rights and interferes with federal regulations.