Judge issues temporary restraining order against three PBMs

• Good Rx Holdings, Inside Rx LLC and MS CVS Pharmacy LLC are allegedly forcing independent pharmacies to accept discount cards, negatively affecting their profits.

A temporary restraining order has been placed on three companies by a Harrison County Chancery Judge in a move Attorney General Lynn Fitch (R) says protects small pharmacies.

The order was approved by the court on April 23. It states that the aim is to protect independent pharmacies from allegedly being forced to accept discount cards that are harmful to their profit margins. The suit alleges Pharmacy Benefit Managers (PBMs) are to blame, and names three companies in particular: Good Rx Holdings, Inside Rx LLC and MS CVS Pharmacy LLC.  

“For years, Mississippi’s independent pharmacies have been forced to take artificially low reimbursements because the PBMs have used their influence and leverage to effectively force non-negotiable contracts on them,” Fitch said in a statement. “These small business owners are already operating on razor-thin profit margins and this unfair PBM practice, especially when coupled by fees levied by GoodRx, often means they spend more to fill a prescription than they make on it.”

Inside Rx disputes the claims made by the Attorney General.

“The allegations against Inside Rx in this lawsuit are false. Pharmacies are not forced or required to accept the Inside Rx discount card. Inside Rx is a voluntary program that helps make prescription drugs more accessible for many Americans. Inside Rx will vigorously defend itself against these claims,” an Inside Rx spokesperson stated in an emailed response.

Like Fitch, House Drug Policy Committee Chair, State Representative Stacey Wilkes (R) is concerned about the alleged practices she says could harm independent pharmacies. 

“The pharmacy submits the claim through the patient’s insurance, but the insurer covertly routes it through a savings card, most commonly GoodRx. As a result, the patient pays the copay, the insurer pays nothing, and the pharmacy is then assessed a processing fee for a discount card it did not voluntarily choose to accept,” Wilkes said. “This practice reflects a clear abdication of responsibility by the insurer, effectively shifting the burden onto the discount cards.” 

Forcing those businesses to accept the discount cards violates Section 83-9-6.1 of the state code, Fitch stated in the request to the court. 

“I’m glad to see the Attorney General obtain the restraining order. We have a state statute from years ago that allows pharmacies to deny those discount cards. Most of the time they lose money by accepting them, they’re actually dispensing at a loss.” Wilkes said. 

Requests for comment from Good Rx and CVS by Magnolia Tribune went unanswered. 

As previously reported, PBMs set the types of medications that can be covered to treat certain conditions. They also set reimbursement rates, process claims, and ultimately pay pharmacies. While designed to reduce prescription drug costs for consumers, there are concerns that PBM practices instead lead to increased prescriptions costs. By controlling approved medication lists and reimbursement rates, PBMs state they use their leverage to negotiate lower prices and rebates with drug manufacturers.

Pharmacists, especially those that operate independently of large chains, allege the work of PBMs leads to unfair reimbursement rates for them while providing better rates to pharmacies affiliated with the PBMs.

One bill that aimed to address the issue, HB 1123, died in the waning hours of the 2025 legislative session after State Rep. John Hines (D) raised a point of order in the Mississippi House over the addition of code sections in the conference report, a practice that violates the chamber’s rules. 

Editor’s note: This story has been edited to correct that Rep. Stacey Wilkes is the House Drug Policy Committee Chair, not Public Health Committee Chair.