At the U.S. Eighth Circuit Court of Appeals last week, Pharmaceutical Care Management Association (PCMA) and North Dakota delivered oral arguments in litigation over state laws regulating some PBM practices. The proceedings were the latest step in PCMA v Wehbi’s winding path through the courts. The circuit court once sided with the PBM lobbying group, but the U.S. Supreme Court vacated that ruling after it unanimously decided to uphold an Arkansas PBM-regulation law.

Bad, broken systems thrive on apathy and inaction. As recent events both inside and outside pharmacy have taught us, it’s on each of us to call out what’s wrong, break patterns of dysfunction, and fix the problem.

Alis Volat Propriis—“She flies with her own wings”—is Oregon’s state motto. The government first adopted the slogan in 1854 as a hat tip to the independent spirit of the pioneers who formed Oregon’s first government. The slogan was replaced by others over the years until lawmakers brought it back in 1987—arguing that it still reflected Oregon’s traditions of independence and innovation.