The Truth About PBM Spread Pricing with Brian Schram
What exactly is spread pricing, and why is it one of the most controversial practices in pharmacy benefits? Brian Schram breaks it down from the broker, employer and PBM side.
About this episode
Chris Estep and Andy Rodriguez sit down with Brian Schram, Vice President of Sales at DisclosedRx, who has seen pharmacy benefits from nearly every angle: broker, employer and PBM executive.
Together they break down the mechanics of spread pricing, why it is so hard to identify, how it affects employer health plans, and why lawsuits, regulation and employer pressure are pulling it into the spotlight.
The episode closes with the questions employers and brokers should ask their PBM to understand where their pharmacy dollars actually go, and what brokers should look for when evaluating pharmacy contracts.
The more transparent the pricing, the harder it is to hide the spread.
Topics covered
- What spread pricing is and how it works
- Why employers often don't know it's happening
- The incentives driving pharmacy benefit costs
- Recent lawsuits and industry scrutiny
- CAA 2026 and the future of PBM transparency
- Questions every employer should ask their PBM
- What brokers should look for in pharmacy contracts
Brian Schram
Vice President of Sales, DisclosedRx
Disclosure: Full Disclosure is sponsored by DisclosedRx, where both hosts work.
Go deeper
What Is PBM Spread Pricing? A Plain-English Guide for Employers
How spread pricing works, why plan sponsors rarely see it, and the contract terms that make it visible.
Pass-Through PBM vs. Traditional PBM: What Employers Should Know
How pass-through pricing and full rebate pass-through change the economics of your pharmacy benefit.
CAA 2026 PBM Reform: What Employers and Brokers Need to Know
The PBM provisions in the Consolidated Appropriations Act, 2026, what they require, and when they take effect.
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