In this episode of Prescription for Better Access, we’re joined by William (Bill) Sarraille, a legal expert on drug access and reimbursement. He discusses two developments shaping the pharmacy benefit landscape: the FTC’s enforcement action involving Express Scripts and PBM reforms in the Consolidated Appropriations Act of 2026. Bill explains what these policy changes could mean for benefit design, drug coverage, employer-sponsored plans, and transparency in the PBM market. We also explore potential impacts on formularies, utilization management, contracting practices, and patient out-of-pocket costs, along with possible unintended consequences for employers, manufacturers, and patients seeking timely and affordable access to medicines.
William (Bill) Sarraille, University of Maryland School of LawLinkedInPharmacy Benefit Managers (PBMs)FTC Settlement2024 Administrative ComplaintCigna HealthcareFair Market Value in HealthcareConsolidated Appropriations Act of 2026Part D PlanPBMs No Longer Profit From Rebates But Plans Benefit – Pink SheetTPA (Third Party Administrators)DOL ProposalCopay Accumulators and MaximizersAmicus Brief, HIV and Hepatitis InstituteQuestions or comments?
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