Express Scripts sues Tennessee over PBM law that would close specialty pharmacy
Less than a month after CVS sued Tennessee over a state law that bars pharmacy benefit managers (PBMs) from operating retail drug stores, Express Scripts has filed its own complaint on behalf of its subsidiary Evernorth.
Evernorth, a care services company and PBM in its own right, operates a specialty pharmacy in Memphis that it would be forced to divest from under the terms of the state regulation, set to go into effect in 2027.
That specialty pharmacy is Accredo, which supplies high-cost drugs to health plans at group rates. Often the pharmaceuticals it supplies are used to treat rare and serious conditions, and there may not be an inexpensive generic available at all.
The CVS complaint is more clear-cut, as it operates stores that are open to the public, where prescriptions can be filled and an array of products can be purchased by anyone.
While not technically a consumer-facing retail space, the Tennessee regulation bans any PBM from operating a pharmacy location that dispenses drugs directly to customers, be it patients or health plans—and Accredo would qualify.
In an announcement, Express Scripts questioned the logic of the “shortsighted law,” which it argues violates the U.S. Constitution and is unenforceable.
“Tennessee lawmakers are risking the health and well-being of Tennesseans who rely on the medicines and care they receive from our family of pharmacies,” Susan Peppers, vice president of pharmacy practice, Evernorth Health Services, said. “If this misguided law takes effect, hundreds of thousands of patients could be left scrambling to navigate pharmacy closures and find new ways to access their medications and essential clinical support.”
“Tennesseans deserve convenient, affordable care, and we are doing everything we can to ensure their access to this care continues,” she added.
Creating pharmacy deserts?
In summarizing the key points of its legal complaint, Express Scripts extolled the benefits Accredo provides to residents of the state, including the shipment of over 168,000 prescriptions to 32,000 residents in 2025 alone.
Further, the company said there are virtually no options for patients to get access to these critical drugs anywhere else, as more than 20 different medicines “are available to dispense only through Accredo.”
This includes cancer treatments, the company added. It also said that many of its patients live in areas of the state where there are no retail pharmacies, meaning they rely on the drugs Accredo delivers to survive.
Express Scripts made no mention of selling the specialty pharmacy. Instead, it seems to be threatening to close it and any other pharmacy linked to Express Scripts.
The PBM stated that its pharmacies employ 1,200 people across the state.
To avoid that, the group is hoping a federal judge agrees that the state has overstepped its regulatory authority.
Multiple other states are considering similar legislation, with Arkansas passing a law that is very similar to the one in Tennessee. That law is also being challenged by CVS and Express Scripts.
This is a developing story.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.