⚖ Oral Arguments, with Context

Drugmakers and West Virginia fight over where discounted medicines can be delivered. The federal three-forty-B program lets eligible hospitals and clinics buy drugs at discounted prices. Many use outside contract pharmacies to fill their patients' prescriptions. Beginning in twenty twenty, manufacturers started restricting those delivery arrangements. West Virginia responded in twenty twenty-four with a law barring restrictions on delivery to pharmacies chosen by eligible providers. It also bars manufacturers from demanding claims data as a delivery condition unless the federal health department requires that data. The industry association PhRMA, AbbVie, and Novartis sued state officials. A district judge temporarily blocked the law, and a divided three-judge appeals panel upheld that block. Now a larger Fourth Circuit bench is rehearing the case. The key term is preemption: when federal law overrides state law. The federal statute sets discount prices but does not specify contract-pharmacy delivery rules. Does that gap leave states free to regulate delivery, or protect manufacturers' freedom within the federal bargain? Michael Williams, for West Virginia, will argue that the state regulates delivery without changing federal prices or eligibility.

PhRMA v. McCuskey (No. 25-1054) — U.S. Court of Appeals for the Fourth Circuit, argued October 27, 2026.