Episode 2: Spread Pricing

Episode 2: The Truth About Spread Pricing with Brian Schram What exactly is spread pricing—and why has it become one of the most controversial topics in pharmacy benefits? In this episode of Full Disclosure, Chris Estep and Andy Rodriguez sit down with DisclosedRx Vice President of Sales Brian Schram, someone who has seen the industry from nearly every perspective imaginable: broker, employer, and now PBM executive. That unique journey gives Brian a front-row seat to how pharmacy pricing really works—and where employers often get left in the dark. Together, we break down the mechanics of spread pricing, why it's so difficult to identify, how it impacts employer health plans, and why increasing scrutiny from lawsuits, regulations, and employers themselves is bringing the issue into the spotlight. We also discuss what employers and brokers should be asking their PBMs if they want to understand where their pharmacy dollars are actually going. Whether you're a broker, consultant, employer, or simply trying to understand why prescription drug costs continue to rise, this episode offers a candid look at one of the most misunderstood—and costly—practices in healthcare. 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 be asking their PBM • What brokers should look for when evaluating pharmacy contracts The more transparent the pricing, the harder it is to hide the spread. 🎙️ Full Disclosure with Chris Estep & Andy Rodriguez — Where Transparency Takes the Mic.