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In a blow to pharmacy benefit managers, the U.S. Supreme Court ruled that an Arkansas law can be used to regulate these controversial middlemen in the pharmaceutical supply chain.

The state law governs reimbursements rates that pharmacy benefit managers, or PBMs, must pay to pharmacies. Specifically, the law requires PBMs to reimburse pharmacies at or above their wholesale costs paid for generic drugs, and also prevents them from paying their own drug stores more than what is paid to other pharmacies. CVS Health, for instance, owns both a PBM and pharmacies.

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