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Hawaii passed Act 143 to protect 340B covered entities’ ability to use contract pharmacies. Since the law was enacted, manufacturers have challenged it in court. Despite the ongoing litigation, the statute remains in effect and continues to apply to covered entities operating in Hawaii.
Several of the same manufacturers challenging Hawaii’s law are also contesting similar 340B contract pharmacy access laws in other states. While the legal process continues, Hawaii’s operational environment has not changed: Act 143 remains active.
AbbVie, AstraZeneca, and PhRMA are the primary manufacturers and trade groups challenging Act 143. These companies are also leading broader legal efforts against state-level contract pharmacy access protections across the country.
Nationally, court trackers show that judges have often allowed state 340B contract pharmacy laws to remain in place while lawsuits move forward. In many cases, courts have declined to block enforcement during early stages of litigation. Hawaii has generally followed this pattern so far.
Hawaii has seen two key procedural rulings to date.
In the AstraZeneca case, the court denied the company’s request for a preliminary injunction. A preliminary injunction would have temporarily blocked enforcement of Act 143 while the lawsuit proceeds. Because the request was denied, Hawaii’s contract pharmacy access law remains enforceable during the litigation. For covered entities, this means there is no operational change as a result of this ruling. Contract pharmacy protections remain in place, and manufacturer policies tied to Hawaii continue to apply.
In a separate case brought by AbbVie and PhRMA, the court denied the state’s motion to dismiss the lawsuit. This means the manufacturers’ challenge will continue through the legal process rather than being dismissed early. However, the denial of the motion to dismiss does not invalidate Act 143 or pause enforcement. For covered entities, the practical impact is the same: the law remains active while the case moves forward.
Neither ruling represents a final decision on the merits of the law. Both cases will continue through further legal proceedings.
Hawaii’s 340B contract pharmacy access law is structured somewhat differently from some other state statutes.
Act 143 allows manufacturers to require claims-level data submission as a condition for providing 340B pricing at unlimited contract pharmacies. In practical terms, manufacturers may request detailed dispensing data in exchange for honoring 340B pricing in Hawaii.
The law also imposes annual reporting requirements on covered entities. Organizations must submit a yearly report describing their contract pharmacy use to the Healthcare Association of Hawaii.
Because of this structure, Hawaii’s law is often viewed as less restrictive on manufacturers than certain other state laws. It preserves contract pharmacy access protections while still allowing manufacturers to collect claims-level data.
In response to Act 143, a number of manufacturers have issued Hawaii-specific policy updates. To date, approximately ten manufacturers have formally exempted Hawaii covered entities from certain nationwide contract pharmacy restrictions.
However, many of these exemptions require submission of claims-level data for all contract pharmacies in order to access 340B pricing. This means covered entities may need to submit data across multiple pharmacies and manufacturer platforms.
Operationally, submitting claims-level data for all contract pharmacies increases administrative complexity. Files must be formatted correctly, submitted on time, and reconciled against dispensing records. Many submissions occur through ESP or manufacturer-specific portals. As the number of pharmacies increases, so does the volume of files and the potential for submission errors or reconciliation issues.
In addition to claims-level data conditions, Act 143 requires covered entities to submit an annual report detailing their contract pharmacy arrangements.
This reporting obligation adds another layer of documentation and oversight. Covered entities must maintain accurate records of their contract pharmacy relationships and ensure the information reported aligns with their operational structure.
The lawsuits from AbbVie, AstraZeneca, and PhRMA are still ongoing, and final court decisions have not yet been issued. However, Hawaii’s Act 143 remains in effect during the litigation process.
For covered entities, this means:
Until a court issues a final ruling that changes the statute’s status, operations in Hawaii should continue under the current legal framework. The law is active, and compliance responsibilities remain as they stand today.
