The Fifth Circuit Court of Appeals issued a mixed ruling Tuesday in an antitrust case involving pharmacy benefit management network access, partially reversing a district court's dismissal while affirming other aspects of the lower court's decision.

In *Rx Solutions, Inc. v. Caremark, L.L.C.*, the appeals court affirmed the U.S. District Court for the Southern District of Mississippi's dismissal of federal antitrust claims but reversed the district court's finding that it lacked diversity jurisdiction over remaining state law claims.

The case stems from Caremark LLC's denial of Rx Solutions Inc.'s application to join Caremark's pharmacy benefit management network. Rx Solutions, a retail pharmacy in Mississippi owned equally by brothers Logan Cain and Evan Cain and operated by CEO Louis Bond, filed suit against both Caremark and CVS Pharmacy Inc.

Circuit Judge Cory T. Wilson, writing for a three-judge panel that included Judges Southwick and Higginson, explained that Rx Solutions had brought "two federal antitrust claims and three state law claims" following the network denial.

The district court had originally dismissed the federal antitrust claims and declined to exercise supplemental jurisdiction over the state law claims, ruling it lacked diversity jurisdiction. However, the Fifth Circuit determined that complete diversity of citizenship existed between the parties, allowing the federal court to hear the state law claims under diversity jurisdiction.

The appeals court remanded the case to the district court with instructions to consider the merits of the remaining state law claims. The ruling represents a significant development for independent pharmacies challenging exclusion from major PBM networks, as it provides a pathway for state-based antitrust and business tort claims to proceed in federal court when diversity jurisdiction requirements are met.