A federal appeals court has upheld Missouri’s law protecting 340B contract pharmacies, rejecting Novartis’ bid to block enforcement of the statute while its lawsuit proceeds.
In a July 1 opinion, the U.S. Court of Appeals for the 8th Circuit affirmed a lower court’s denial of Novartis’ request for a preliminary injunction against Missouri Senate Bill 751. The law bars drug manufacturers from restricting the delivery of 340B drugs to pharmacies that contract with Missouri 340B covered entities, unless HHS prohibits the arrangement.
Novartis argued the law is preempted by federal statute and violates the Constitution’s dormant Commerce Clause because it prevents manufacturers from limiting the number of contract pharmacies that can dispense 340B drugs. The 8th Circuit rejected those arguments, finding Novartis had not shown it was likely to succeed on the merits of its claims.
The court said Missouri’s law regulates the delivery of 340B drugs rather than their pricing and does not conflict with the federal 340B program. It also found the statute does not unlawfully burden interstate commerce or discriminate against out-of-state manufacturers.
Missouri now joins a growing list of states whose 340B contract pharmacy protections have survived drugmaker challenges. For instance, the Supreme Court rejected a challenge to Arkansas’ law in December 2024, a Colorado court rejected AbbVie’s push to restrict 340B protections in October 2025, a Hawaii federal court backed that state’s contract pharmacy law in February of this year, and the 5th Circuit U.S. Court of Appeals upheld Mississippi’s protections April 9.
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