Independent Pharmacy Groups Back Iowa PBM Regulation in Federal Court

ALEXANDRIA, Va. (Oct. 8, 2025) – A group of organizations representing independent pharmacies filed a legal brief in federal court supporting pharmacy benefit manager regulations in Iowa challenged by business groups and insurance plans.

The National Community Pharmacists Association (NCPA), the Iowa Pharmacy Association (IPA), the American Pharmacists Association (APhA), and the Independent Pharmacy Cooperative (IPC) filed an amicus brief urging the U.S. Court of Appeals for the 8th Circuit to reject a challenge to an Iowa law regulating PBM practices they say are driving independent pharmacies out of business. The law, Senate File 383, is being challenged by groups representing employers and insurance companies. It is being defended by Iowa State Insurance Commissioner Doug Ommen. A lower district court recently issued an injunction barring the state from enforcing the law.

The employer and insurance groups say the law is preempted by the federal Employee Retirement Income Security Act of 1974 (ERISA) which regulates employee benefits plans. The independent pharmacy groups say PBMs aren’t employee benefits plans. They’re merely administrators hired by the plans, and so they can be regulated.

“ERISA does not regulate the business practices of third-party providers that, like PBMs, sell goods and services to ERISA plans. Otherwise, ERISA would displace state laws regulating everything from doctors, accountants and lawyers, to hospitals and insurers,” say the groups in their brief.

“It’s a flimsy legal argument that was already unanimously rejected by the U.S. Supreme Court in 2020,” said NCPA CEO B. Douglas Hoey. “Since that decision, almost every state in the country has passed or introduced some kind of PBM reform to stop their egregious practices.”

“Iowa has the right, and the responsibility, to stop PBM tactics that close community pharmacies and harm patients. SF 383 is a common-sense check on middlemen and it’s essential to preserving access in rural Iowa where a single closure can leave an entire county without care. We’re proud to stand with NCPA, APhA, and IPC to protect patient access in Iowa,” said IPA’s Matthew Pitlick, PharmD, BCPS.

“Iowa’s PBM reform law is about protecting patient access to care,” said Michael D. Hogue, PharmD, CEO of APhA. “States must be able to defend their authority to regulate PBMs and ensure patients aren’t denied the pharmacy services they need.”

“The Independent Pharmacy Cooperative stands firmly with our partners and patients in this critical fight. Senate File 383 represents a vital check on obscure third-party PBM practices, and not on ERISA plans directly. IPC is proud to join this amicus brief in support of our independent pharmacy members and we call on the 8th Circuit to uphold Iowa's common-sense law and put patient care before PBM profits,” said Marc Essensa, president and CEO of IPC.