AHA urges en banc review of 4th Circuit’s West Virginia 340B contract pharmacy law decision

The AHA and others April 17 filed an amicus brief requesting the U.S. Court of Appeals for the 4th Circuit grant en banc review of a panel decision that invalidated West Virginia's law protecting 340B contract pharmacy arrangements. An en banc review would allow the full court of appeals to rehear the case and reconsider the panel's ruling.

The AHA argues that the ruling preempted state protections for the 340B Drug Pricing Program, departed from established legal principles, and adopted a novel legal test without full briefing from the states. According to the brief, the panel decision also conflicts with the 4th Circuit's own precedent; rulings from the 5th and 8th Circuits upholding similar laws in Louisiana and Arkansas, respectively; and the overwhelming majority of federal courts that have reviewed the legality of these laws.

The brief also explained why the issues presented in the case are "exceptionally important to West Virginia patients and caregivers." Quoting the dissenting judge from the original pane, the AHA argued, "the 'consequences' of the panel decision 'are profound and immediate: they jeopardize the viability of these hospitals, their essential services, and receipt of drugs that many low-income patients in West Virginia rely on.' If that is not exceptionally important, Amici do not know what is."

The AHA was joined in the filing by the West Virginia Hospital Association, 340B Health and American Society of Health-System Pharmacists. The 4th Circuit March 31 upheld a preliminary injunction issued by the U.S. District Court for the District of West Virginia blocking the state from enforcing S.B. 325, its law requiring drug companies to provide access to 340B drug discounts to purchases through contract pharmacies. PhRMA and drug manufacturers had sued in December 2024 to enjoin the law.