Washington, D.C. — Following news that Arkansas state lawmakers in both the House and Senate have passed HB 1150, a structural separation bill that prohibits pharmacy benefit managers (PBMs) from owning pharmacies, the American Economic Liberties Project released the following statement.

“By taking this commonsense step to structurally separate PBMs and pharmacies, Arkansas lawmakers are breaking up the Big Medicine conflicts of interest that sit at the heart of healthcare industry,” said Benjamin Jolley, PharmD, Senior Fellow for Healthcare at the American Economic Liberties Project. “It’s abundantly clear that Big Medicine-pharmacy conglomerates can’t be responsible for saving employers money on medications and responsible for selling medications at high prices simultaneously. The temptation to force patients to their own pharmacies and manipulate pricing in their favor is far too strong. Through HB 1150, Arkansas recognizes this reality and is taking action to ensure that the adversarial relationship between PBM and pharmacy serves to benefit the public — not a small group of Fortune 10 companies. We’re thrilled to see the legislature move it forward and urge Governor Sanders to swiftly sign off on this bill.”

PBMs are middlemen who negotiate prescription drug benefits on behalf of health plans with drug manufacturers and pharmacies. The “Big Three” PBMs – CVS Caremark, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx – control nearly 80% of U.S. prescription drug claims. They leverage this market power to demand untenably low reimbursement rates from independent pharmacies in exchange for inclusion in their networks. Many pharmacies accept these rates for fear of losing access to a large share of their customer base. But these rates are accelerating the pharmacy closure epidemic. Economic Liberties research shows that at least 25 Arkansas pharmacies closed between January 2024 and February 2025.

HB 1150 mirrors the Patients Before Monopolies Act (S.5503, H.R. 10362), introduced by Sens. Elizabeth Warren (D-MA) and Josh Hawley (R-MO) and Reps. Jake Auchincloss (D-MA-04) and Diana Harshbarger (R-TN-01) late last session. This federal legislation would force insurers and PBMs to divest their pharmacy businesses within three years, eliminating the conflicts of interest inherent to their common ownership.

Learn more about the Break Up Big Medicine initiative here.

Learn more about Economic Liberties here.

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The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; foreign trade arrangements support domestic security and democracy; and wealth is broadly distributed to support equitable political power.