.png)
The legal landscape surrounding 340B contract pharmacy access is rapidly evolving, with several states enacting laws to protect these arrangements and facing subsequent legal challenges from pharmaceutical manufacturers. Mississippi and Missouri are at the forefront of this legal battle, each experiencing significant developments in recent months.
In Mississippi, the state enacted legislation to ensure that 340B-covered entities can access discounted drugs through contract pharmacies. This move was met with opposition from pharmaceutical companies, including Novartis and the Pharmaceutical Research and Manufacturers of America (PhRMA), who filed lawsuits challenging the law.
In July 2024, a federal judge denied the plaintiffs' request for a preliminary injunction, allowing the law to remain in effect during the litigation process. The court indicated that the law likely promotes the 340B program's goal of ensuring patient access to affordable medications.
The case progressed to the U.S. Court of Appeals for the Fifth Circuit, which heard oral arguments in April 2025. The outcome of this appeal will be pivotal in determining the extent of state authority in regulating 340B contract pharmacy arrangements.
Missouri's legislature passed a law mandating that pharmaceutical manufacturers provide 340B discounts to all contract pharmacies affiliated with covered entities. This legislation prompted lawsuits from several drugmakers, including Novartis, AstraZeneca, AbbVie, and PhRMA, who argued that the state law conflicts with federal statutes and imposes unconstitutional restrictions on interstate commerce.
In February 2025, a federal judge partially dismissed the lawsuits filed by AstraZeneca and PhRMA, weakening the pharmaceutical industry's position against the state's law. The court's decision suggests a judicial willingness to uphold state measures that aim to protect 340B contract pharmacy arrangements.
The legal disputes in Mississippi and Missouri are part of a larger national conversation about the role of state governments in regulating the 340B program. With the U.S. Supreme Court declining to hear a similar challenge to Arkansas's 340B contract pharmacy law, lower court decisions are becoming increasingly significant in shaping the program's future.
As more states consider legislation to protect 340B contract pharmacy arrangements, the outcomes of these legal battles will have far-reaching implications for covered entities, pharmaceutical manufacturers, and patients relying on affordable medications.
Stay Informed
For healthcare providers and stakeholders involved in the 340B program, it's crucial to monitor these legal developments closely. Understanding the evolving legal landscape will help ensure compliance and advocate effectively for policies that support patient access to necessary medications.
