Ohio Attorney General Mike DeWine will support Arkansas in its bid to get the U.S. Supreme Court to review a lower-court ruling throwing out state regulations of pharmacy middlemen known as pharmacy benefit managers.

A spokesman for DeWine, who also is governor-elect, said Tuesday that DeWine would sign on to a friend-of-the-court brief along with state attorneys general in at least 24 states plus the District of Columbia. It urges the high court to take up the Arkansas appeal. Arkansas is arguing that the 8th U.S. Circuit Court of Appeals wrongly ruled that state regulations of a practice known as "spread pricing" violate the the Employee Retirement Income Security Act of 1974, which is better known as ERISA.

As part of its yearlong Side Effects investigation, the Columbus Dispatch has been examining spread pricing in the Ohio Medicaid system by benefit managers such as CVS Caremark.

A data analysis by the newspaper prompted one by the Ohio Department of Medicaid. A consultant hired by the agency determined that PBMs used spread pricing to bill taxpayers $224 million more a year for drugs than they were paying pharmacists, generating excess profit of as much as $187 million. Those stories were cited by Arkansas Attorney General Leslie Rutledge in her appeal to the Supreme Court.

The Ohio General Assembly is considering legislation to address the situation, the Ohio Department of Medicaid is engaged in a major reform of the way the program pays for prescription medications for Ohio's poorest residents, and DeWine is considering litigation.

“While our office continues to work with outside counsel as we aggressively investigate and pursue potential litigation against PBMs, we believe it is important also to support other states in defense of their rights to enact laws regulating and reforming this industry,” the DeWine spokesman said in an email.

In her writ asking the Supreme Court to take up the Arkansas case, Rutledge said, "Thirty-six states have enacted legislation to curb abusive prescription drug reimbursement practices by claims-processing middlemen — known as pharmacy benefit managers (PBMs) — who make money on the spread between the rates at which they reimburse pharmacies and the drug prices they charge health plans." She added that in response, an industry group, "has launched a barrage of litigation" arguing that such state regulations are pre-empted by federal law.

The Pharmaceutical Care Management Association, the industry group named as the respondent in the Arkansas petition, contends that the Arkansas law would harm consumers and employers.

“We continue to believe the 8th Circuit Court of Appeals ruled correctly on ERISA and Medicare Part D preemption with regard to PCMA’s opposition to Arkansas Act 900," the group said in a written statement. "The legislation would have raised prescription drug costs for Arkansas consumers and employers by mandating higher payments to independent drug stores and removing incentives to dispense lower-priced options when available.”

In a related matter, CVS on Nov. 9 wrote to all the members of the Ohio General Assembly to take issue with the Dispatch's reporting.

"There has been no intent to 'price gouge' or 'take advantage of the spread model,' as was suggested in media reports," wrote CVS Health Senior State Government Director Erik Woehrmann. As with PCMA, CVS contends that its pharmacy benefit management services save money for consumers and taxpayers.