FTC Settlement Ushers in Net Pricing Drug Channel
The FTC’s landmark settlement with Express Scripts dismantles the PBM’s current incentives and launches a Net Pricing Drug Channel (NPDC): patient costs will be based on net price, rebates must be passed through to patients, formulary bias toward high-WAC drugs ends, direct-to-consumer pricing via TrumpRx is enabled, manufacturer fees must be delinked from list prices, and retailers will be reimbursed on a cost-plus basis. The Ascent Health Services GPO will move from Switzerland to the US, with a monitor and compliance reports and a deadline of January 1, 2028, signaling sweeping changes for plan sponsors, pharmacies, manufacturers, and PBM competitors.