HJAR Sep/Oct 2025

REFLECTIONS 24 SEP / OCT 2025 I  HEALTHCARE JOURNAL OF ARKANSAS   Laws Meant to Improve Arkansans’ Access to Prescription Drugs Set to Go into Effect Nonprofit hospitals will be allowed to hold retail pharmacy permits, and drug manufacturers will face restrictions on their ability to limit the availability of drugs by Tess Vrbin, Arkansas Advocate, arkansasadvocate.com Arkansas lawmakers overwhelmingly approved three laws during the 2025 leg- islative session meant to increase patients’ access to prescription medication. One of those laws has since been blocked in federal court, but the other two went into effect in August. Act 52 removes the state’s ban on non- profit hospitals holding pharmacy permits. Supporters of the law, including some of the state’s largest hospital systems, said patients should benefit from hospital pharmacies’ capacity to afford more expensive drugs and remain open at all hours compared to local independent pharmacies. Additionally, Act 630 prohibits drug man- ufacturers from restricting the availability of medication to a “limited distribution net- work of out-of-state pharmacies.” Republican Rep. BrandonAchor of Mau- melle, a practicing pharmacist and the lead sponsor of Act 630, said in an interview that manufacturers have the power to limit which pharmacies can purchase their drugs. He called this “a huge public safety issue,” especially when the availability of some drugs is limited to mail-order pharmacies. “These patients should not be contingent on an airplane or a FedEx truck,”Achor told a House committee in March. “They should be contingent on being able to access [phar- macies] in real time.” Achor was a co-sponsor and vocal supporter of Act 624 of 2025, which would have banned pharmacy benefit manag- ers (PBMs) from holding a permit to oper- ate a drug store in Arkansas after Jan. 1, 2026. PBMs negotiate prescription benefits among drug manufacturers, distributors, pharmacies, and health insurance provid- ers, and the biggest ones also own pharma- cies and insurers. A federal judge temporarily blocked Act 624 in July after four PBMs and the Phar- maceutical Care Management Associa- tion filed lawsuits against it. Supporters of the law said it would prevent PBMs from financially straining local pharmacies to the point of forcing them to close, but U.S. District Judge Brian Miller ruled that the law “likely violates” the U.S. Constitution’s commerce clause. The state filed a notice of appeal with the court, and both plaintiffs and defendants asked Miller to stay further proceedings until the appeal is decided. The Arkansas Pharmacists Association supported Act 624. CEO John Vinson told a Senate committee inApril that Act 52 will create new pharmacy jobs that could make up for any job loss brought about byAct 624. The initial version of Act 52 would have simply removed the portion of state code banning hospitals from having retail phar- macies. It failed in committee in January after Vinson and others expressed concerns that competition from hospitals’ in-house pharmacies could snuff out independent pharmacies. A2023 bill similar toAct 52 did not advance in the Legislature. Lawmakers amended the eventual Act 52 to replace the deleted code with specific provisions, such as allowing the State Board of Pharmacy to issue permits for retail phar- macies within 250 yards of a nonprofit hos- pital’s physical location in Arkansas, plus one additional pharmacy permit per 100 beds in the hospital. Additionally, Act 52 does not place a limit on the number of retail pharmacies that nonprofit hospitals could operate in con- junction with infusion centers, and it allows these hospitals to direct their pharmacies’ services to underserved areas. Projected Impacts on Patients The Arkansas Pharmacists Association was neutral on the final version of Act 52. Vinson said in an interview that the com- bined impact of Acts 52, 624, and 630 “will benefit a whole lot more people than just this one law alone.” “It’s not just [about] how many pharma- cies there are, but [whether] the patients have a fair market where they can access drugs at the lowest cost where they want to, rather than where a fox guarding the hen- house forces the patients to a pharmacy they don’t want to use through the mail at a higher price,”Vinson said.