AHF Files Supreme Court Amicus Brief in Support of Arkansas’ Appeal of PBM Lawsuit Ruling

In Featured, News by Ged Kenslea


Nation’s largest HIV/AIDS organization files brief of amicus curiae with the U.S. Supreme Court in Rutledge v. Pharmaceutical Care Management Association, a pharmacy benefits manager in Arkansas


 AHF’s amicus is in support of Arkansas’ appeal to the Supreme Court asserting that states’ rights to regulate pharmacy benefits managers are essential to the public health and are not preempted by ERISA


WASHINGTON (March 3, 2020) AIDS Healthcare Foundation (AHF), the nation’s largest HIV/AIDS organization, which operates 68 outpatient HIV medical clinics as well as 55 HIV specialty pharmacies across the country, filed a brief of amicus curiae with the United States Supreme Court in the case Rutledge v. Pharmaceutical Care Management Association, a case that centers on the question of whether states can take necessary steps to protect the public health and slow the spread of infectious diseases like HIV/AIDS, or if such steps are preempted by federal law.


AHF’s amicus brief was filed yesterday (March 2, 2020) and submitted “… in support of Petitioner Leslie Rutledge in her capacity as Attorney General of the State of Arkansas in order to ensure a proper understanding of the provision of pharmacy services to people living with HIV/AIDS and the impact of pharmacy benefit manager (PBM) prescription drug pricing and reimbursement actions on the public health.”


PBMs can exercise enormous economic leverage over pharmacies by virtually unilaterally setting pharmacy prescription drug reimbursement rates, often below the wholesale cost of the drug, causing pharmacies to lose money on drug sales.


“The Arkansas law at issue here requires PBMs to reimburse pharmacies at at least the cost of the drug so that pharmacies have the resources to provide needed services that keep people taking their medicines,” said Tom Myers, General Counsel for AIDS Healthcare Foundation. “This is especially important for people with HIV/AIDS, because taking AIDS medications regularly not only keeps people healthy, it prevents the spread of new infections. Without this law, people will become sicker and more people will become infected. We hope the Supreme Court will recognize the importance of this law to the public health and will uphold it.”


The Role of Pharmacy Services in Successful Management of HIV/AIDS Patients

HIV/AIDS is an infectious disease which can be fatal if not treated. People infected require a lifetime of medical care and services, including adhering to medication regimens that can cost upwards of $36,000 per year. In addition, it is estimated that the lifetime medical costs for an individual who becomes infected with HIV at age 35 are $326,500, with 60% of those expenses attributable to the costs of antiretroviral medication.[1]


Comprehensive pharmacy services play a crucial role in both the health and well-being of HIV/AIDS patients AND in the prevention of new infections. When people with HIV/AIDS are successfully adherent to their drug regimens, they reduce the amount of HIV in their systems to such a small amount that its presence is virtually undetectable and are they considered ‘virally suppressed,’ and their infection can be a chronic, but manageable disease rather than a fatal one.


Just as important: people living with HIV/AIDS who are virally suppressed are rendered virtually non-infectious, meaning it is extremely difficult for them to transmit their infections. Thus, medication adherence not only keeps people healthy, it prevents new infections from occurring.[2]


“While just 45% of all Americans who have HIV/AIDS are virally suppressed, fully 69% of AHF’s clients have achieved viral suppression thanks in large part to our comprehensive pharmacy and support services,” added AHF’s Myers. “Unfortunately, lower courts have found this Arkansas law preempted by federal ERISA.  This finding is bad because it hamstrings states’ traditional role in protecting the public health-they cannot take steps to effectively prevent the spread of infectious disease. It will also result in sicker people and more infections.  We filed this amicus brief to support the state of Arkansas and protect our clients nationwide.”


AHF’s amicus brief concludes “Arkansas’ law takes an important step to protect the public health. It is not preempted by ERISA and, if it is struck down, it will inevitably result in sicker Americans and increased infections. For the foregoing reasons and to protect the public health, amicus AIDS Healthcare Foundation respectfully request that this Court overrule the decision of the 8th Circuit and uphold the Arkansas law.”


Background on Rutledge v. Pharmaceutical Care Management Association

For a fuller background on the history of Rutledge v. Pharmaceutical Care Management Association, please visit Ballotpedia News (“U.S. Supreme Court accepts three new cases for October 2019-2020 term” January 16, 2020).

[1] Tiarney D. Ritchwood, et al, “Trends in health-care expenditure among people living with HIV/AIDS in the United States: evidence from 10 Years of nationally representative data,” 16 Int. J. Equity Health 188 (2017), available at https://doi.org/10.1186/s12939-017-0683-y

[2] Centers for Disease Control and Prevention, “HIV Treatment as Prevention,” available at https://www.cdc.gov/hiv/risk/art/index.html (Last visited Feb. 27, 2020)


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