Lily V. Barrett, an associate in Reed Smith's Washington D.C. office co-authored this article.

A federal district court in Missouri allowed certain claims brought by an independent retail pharmacy to proceed against Express Scripts, Inc. (“ESI”), including claims in which the pharmacy alleged violations of Arkansas’s laws regulating pharmacy benefit managers (“PBMs”).

On November 18, 2025, the United States District Court for the Eastern District of Missouri issued an order partially denying ESI’s motion to dismiss in a case brought against it by an independent retail pharmacy regarding ESI’s reimbursement practices. Lackie Drug Store, Inc. v. Express Scripts, Inc., 2025 U.S. Dist. LEXIS 226620 (E.D. Mo. 2025).

Lackie Drug Store, Inc. (“Lackie”), an independent retail pharmacy based in Lonoke, Arkansas, filed suit against ESI, alleging in part that ESI violated the Arkansas Deceptive Trade Practices Act (“Act”) (Ark. Code Ann. § 17-92-507). The Act requires PBMs to provide covered pharmacies access to PBMs’ Maximum Allowable Cost (“MAC”) lists on a timely basis and prompt notifications regarding updates to MAC lists. The Act also requires PBMs to establish a reasonable administrative appeal procedure allowing pharmacies to challenge a MAC list and relevant reimbursements as well as prohibits PBMs from reimbursing pharmacies and pharmacists in the state an amount less than that which the PBM reimburses its affiliates for the same services. 

Lackie alleged that ESI violated the Act by:

• (1) failing to provide Lackie with access to its MAC list;
• (2) failing to timely update its MAC list;
• (3) failing to provide Lackie with prompt notification of updates to its MAC list;
• (4) failing to provide reasonable administrative appeal procedures to allow Lackie to challenge MAC reimbursements;
• (5) reimbursing Lackie less than it reimbursed Express Script Affiliates for the same pharmacist services; and
• (6) reimbursing Lackie less than the national average drug acquisition cost (“NADAC”) and wholesale acquisition cost (“WAC”).

ESI filed a motion to dismiss all counts filed against it.  With respect to the Act, ESI argued that the Act does not apply because the law governs only consumer-oriented action.  To support this argument, ESI contended that the dispute between ESI and Lackie was merely a contractual dispute between businesses and that Lackie had made no allegations that Arkansas consumers paid more for their prescriptions based on ESI’s practices.  ESI further moved to dismiss Lackie’s request for declaratory and injunctive relief on the grounds that that Act confers no private right of action.

The district court disagreed with ESI’s reasoning with respect to these counts and refused to dismiss Lackie’s claims under the Act, including Lackie’s request for declaratory and injunctive relief.  The court determined that ESI’s claim that the Act applies only to consumer-oriented acts or practices is a requirement that does not appear in the statute, which was intended to govern the conduct of PBMs, pharmacies, and pharmacists.  Additionally, the court found that ESI’s interpretation of the statute would render the enforcement mechanism in the Act “meaningless.”  Finally, the court concluded that it could issue declaratory and injunctive relief if it ultimately finds that ESI violated the Act, and that a request for an injunction is not a cause of action but a remedy.

The court did dismiss other counts Lackie brought against ESI, including allegations that ESI violated the Arkansas Unfair Practices Act for treating its entities more favorably than Lackie, as well as requests for unjust enrichment for reducing Lackie’s reimbursements, equitable estoppel that would have required ESI to halt enforcement of its MAC pricing, and restitution for reduced reimbursements.  Lastly, the court granted ESI’s motion to strike the class action allegations in the complaint on the basis that the parties, through their agreement, had previously agreed to waive class-action litigation. 

Reed Smith recently hosted the webinar “Navigating the Evolving PBM Landscape: Key Policy and Litigation Developments,” and will continue to follow developments in the PBM litigation landscape.  If you have any questions about this case or about PBM litigation, please do not hesitate to reach out to the authors or the health care lawyers at Reed Smith.