8th Circuit Rejects Novartis's Bid to Block Missouri's 340B Contract-Pharmacy Law — Another State Shield Survives a Manufacturer Challenge

On July 1, 2026, the 8th U.S. Circuit Court of Appeals (Novartis Pharmaceuticals Corp. v. Hanaway, No. 25-1619) affirmed the district court's denial of Novartis's preliminary-injunction bid against Missouri's S.B. 751, which requires manufacturers to deliver 340B drugs to all contract pharmacies serving Missouri covered entities.

Per the Missouri Hospital Association, the court found Novartis unlikely to prevail on the merits — any extraterritorial effect of the statute was 'negligible and nondiscriminatory toward out-of-state entities' — and rejected Novartis's attempt to revisit its position on federal preemption; the case now returns to the district court for merits proceedings.

The Missouri Primary Care Association (the state's FQHC association) intervened alongside MHA to defend the law. The ruling adds another upheld state 340B contract-pharmacy shield to the circuit-by-circuit map FQHC pharmacy directors are tracking, weeks after Washington's law survived a separate challenge in June.