Express Scripts sues Tennessee to block pharmacy ownership law

Cigna's pharmacy benefit manager Express Scripts filed a lawsuit challenging a Tennessee law that restricts pharmacy ownership by PBMs and insurers. The state law, designed to protect independent pharmacies from vertical integration by large PBMs, is now facing a legal test that could influence similar legislation in other states. Express Scripts argues the law interferes with interstate commerce and conflicts with federal ERISA provisions. The case highlights the ongoing tension between state regulators seeking to preserve local pharmacy access and national PBM operators consolidating market power. A ruling against the Tennessee law could accelerate PBM consolidation, potentially tightening formularies and narrowing pharmacy networks for providers and patients.