With less than 24 hours left in the legislative session, Louisiana lawmakers are locked in a fierce battle over a proposal that would change the way pharmacies are allowed to operate in the state.
Last-minute changes made to House Bill 358 have prompted a massive public lobbying campaign from drugstore chain CVS, with a text message sent to customers Wednesday afternoon that said the legislation "threatens to close your CVS pharmacy."
The legislation, designed to favor independent pharmacies, would ban pharmacy benefits managers from owning or partially owning pharmacies in Louisiana, a move that supporters say represents a strong pushback against corporations squeezing consumers.
If passed, the bill would force the closure of over 100 CVS pharmacies in Louisiana, company officials say.
If HB 358 is signed into law, it would not go into effect until 2026.
Here's what to know.
What is a pharmacy benefits manager?
Pharmacy benefits managers are companies that negotiate lower drug prices by acting as middlemen between drug manufacturers, insurance companies and pharmacies.
Their roles have expanded over the decades and PBMs are now at the center of drug distribution. Supporters say they can help keep costs down, but critics argue benefit managers pocket too much of the savings.
PBMs purchase drugs from drug wholesalers. They are also responsible for deciding which drugs are and aren't covered by your insurance, and how much you have to pay for prescription drugs.
According to a 2024 report from the Federal Trade Commission, the top three PBMs in the country include CVS Caremark, Express Scripts, and OptumRx. Together, the FTC says they manage 79% of of prescriptions filled in the U.S. for about 270 million people. The FTC launched a broad investigation into pharmacy benefit managers in 2022.
Other state legislatures have moved to restrict PBMs in recent years, including Arkansas, California, Maine and New York. Congress also aimed to pass legislation last year to regulate PBMs.
Pharmacy operations in Louisiana
How could the bill affect where Louisianans can get their prescriptions filled? The full scope of the legislation is still coming into view.
CVS retail pharmacies are owned by PBM CVS-Caremark, and officials say the bill's passage would close hundreds of their neighborhood pharmacies. CVS-Caremark also owns a mail service pharmacy, though it's unclear if those operations would be affected by the bill.
Local, independent pharmacies would not be directly affected by the bill. According to the Louisiana Independent Pharmacies Association, there are roughly 400 independent community pharmacies in the state. You can find your closest independent pharmacy on their website.
What's next?
HB 358 has already received approval from House members.
Now, on the last day of the session, it must go before state Senate for final approval. The Senate is set to gavel in at 9 a.m. Thursday.
Then, lawmakers in the chamber could choose to vote to approve the bill as is, make amendments or outright reject the bill.
If a majority of senators do decide to approval the bill in its current form, it is likely to receive Gov. Jeff Landry's signature, the last step a bill needs before becoming a law.
Landry has already given public support for the bill, praising it on X Wednesday.
