Ohio Attorney General Dave Yost has joined an important effort by 45 state attorneys general to push the federal government to seek more transparency in prescription-drug transactions through pharmacy benefit managers, and to ensure federal efforts do not pre-empt state transparency laws.

It’s a significant effort because PBMs — the companies that are supposed to represent insurers in drug transactions — have always favored the federal rules and regulations over state laws.

According to a report by the Ohio Capital Journal, the three largest PBMs control approximately 80% of drug transactions. Each of them is also part of giant conglomerates that own insurers and pharmacy operations. For smaller chains and independent pharmacies, it’s hard to fight against that kind of conflict of interest.

So, while it is understandable there are now multiple federal ideas for combating the problem, states have already started passing laws that would force PBMs to be more transparent in their dealings.

“In a letter to the Department of Labor, the coalition urges the adoption of two additional protections,” said Oklahoma Attorney General Gentner Drummond, according to the Capital Journal. “First, they ask the Department to clarify that the rule does not override existing state PBM transparency laws. This is an important safeguard since PBMs have historically argued that federal law preempts state oversight. Second, they ask the Department to commit to coordinating enforcement with state attorneys general, including by referring potential violations of state law to their offices.”

Yost is right to add Ohio to the list of states hoping to get ahead of any potential federal effort that is friendlier than state laws would be to the PBMs and the big corporations they serve. The question now is whether the U.S. Department of Labor will care.