Pharmacy Law Lowdown: Actions Against PBM Practices

In episode 5 of the Pharmacy Law Lowdown, hosts Dae Lee, PharmD, Esq, CPBS, and Lucas Morgan, Esq, shareholders at Buchanan Ingersoll & Rooney, break down the February 2026 Federal Trade Commission (FTC) settlement with Express Scripts—one of the most significant developments in pharmacy benefit manager (PBM) regulation in recent history.

From spread pricing prohibitions to any willing pharmacy protections, the settlement introduces sweeping changes that could fundamentally reshape the PBM-pharmacy relationship for independent pharmacies and plan sponsors nationwide.

“Spread has to be 100% passed through,” said Lee. “It's going to pass that money straight to the independent pharmacy. There will be a heightened level of transparency in the whole drug claim adjudication and payment process.”

Lee and Morgan unpack the settlement's most impactful provisions, including the prohibition on spread pricing, any willing pharmacy network access requirements, and the implication that Express Scripts’ rebate aggregator—Ascent Health Services—relocate its operations from Switzerland to the US.

The hosts also address what this settlement signals for the 2 remaining respondents in the FTC action—CVS Caremark and OptumRx—and why independent pharmacies have reason for cautious optimism as those negotiations continue.

Tune into this episode and stay tuned for more pharmacy law updates throughout the year from Lee and Morgan.

Pharmacy Law Lowdown is a podcast offering from Drug Topics, hosted by Dae Lee, PharmD, Esq, CPBS, and Lucas Morgan, Esq, shareholders at Buchanan Ingersoll & Rooney, a national law firm that provides legal, business, regulatory, and government relations advice to a wide range of clients. All episodes of Pharmacy Law Lowdown will be available in video format via DrugTopics. Check out our most recent episode from earlier this year: Legislative Shifts in 2026 PBM Reform.

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