Independent pharmacy groups back Iowa PBM regulation in federal court

Washington, DC (October 6, 2025) - A group of organizations representing independent pharmacies filed a legal brief today in federal court supporting PBM 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 8^th 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 contend that PBMs aren't employee benefits plans-they're merely administrators hired by the plans, and therefore, can be regulated.

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

"It's a flimsy legal argument that was already unanimously rejected by the U.S. Supreme Court in 2020," said B. Douglas Hoey, CEO of NCPA. "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," said Matthew Pitlick, PharmD, BCPS, executive vice president and CEO of Iowa Pharmacy Association. "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."

"Iowa's PBM reform law is about protecting patient access to care," said Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP, executive vice president and 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," said Marc Essensa, president and CEO of the IPC. "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."

For more information about NCPA, please visit https://www.ncpa.org. For more information about IPA, please visit https://www.iarx.org. For more information about APhA, please visit https://www.pharmacist.com. For more information about IPC, please visit https://www.ipcrx.com.

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