By Neil Brown and Brontë Arreola
The Fourth Circuit recently affirmed a preliminary injunction blocking enforcement of West Virginia Senate Bill 325 which required drug manufacturers to deliver 340B-priced drugs to an unlimited number of contract pharmacies.
The federal 340B program sets up a framework under which participating drug manufacturers provide discounted outpatient drugs to covered entities, including safety-net hospitals and clinics. Covered entities sometimes use contract pharmacies to dispense those drugs. Against that backdrop, West Virginia enacted S.B. 325, W. Va. Code § 60A-8-6a.
S.B. 325 law barred manufacturers from imposing certain limits on contract pharmacy arrangements, prohibited certain data-reporting requirements unless required by HHS, and imposed state penalties of $50,000 per violation.
In Pharm. Research & Mfrs. of Am. v. McCuskey,[1] the Fourth Circuit held that S.B. 325 is likely preempted by federal law because it imposed state-law requirements in an area already governed by the federal 340B program. Applying established preliminary injunction factors including likely success on the merits, irreparable harm, and the balance of equities and public interest, the court affirmed the district court’s injunction against enforcement of the statute.
The decision is already being cited in other cases within the Fourth Circuit. In Maryland, the court in AbbVie, Inc. v. Brown[2] addressed a similar law and relied on McCuskey in its preliminary injunction analysis.
The ruling also adds to a growing circuit split over whether § 340B preempts state laws regulating contract pharmacy arrangements. The Fifth and Eighth Circuits have held that similar state laws are not preempted.[3]
This remains an area to watch as disputes over federal preemption and state authority in the 340B space continue to develop.
[1] Pharm. Research & Mfrs. of Am. v. McCuskey, 171 F.4th 675(4th Cir. 2026).
[2] AbbVie, Inc. v. Brown, Nos. 24-1939, 24-1978, 2026 LX 156170 (4th Cir. April 14, 2026).
[3] See Pharm. Rsch. & Mfrs. of Am. v. McClain, 95 F.4th 1136 (8th Cir. 2024); AbbVie, Inc. v. Fitch, 152 F.4th 635 (5th Cir. 2025); AbbVie, Inc. v. Murrill, 166 F.4th 528 (5th Cir. 2026).