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 Law
• LinkedIn
• Pharmacy Benefit Managers (PBMs)
• FTC Settlement
• 2024 Administrative Complaint
• Cigna Healthcare
• Fair Market Value in Healthcare
• Consolidated Appropriations Act of 2026
• Part D Plan
• PBMs No Longer Profit From Rebates But Plans Benefit – Pink Sheet
• TPA (Third Party Administrators)
• DOL Proposal
• Copay Accumulators and Maximizers
• Amicus Brief, HIV and Hepatitis Institute

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Employers sit at the center of the U.S. health system as the primary funders of coverage for more than 150 million Americans, yet they struggle with rising costs, fragmented vendors, and uneven outcomes. In this episode, we talk with Dan Mendelson, MPP, CEO of Morgan Health at JPMorgan Chase & Co. and Founder and former CEO of Avalere Health. We explore his journey from health policy to now leading Morgan Health’s efforts to improve the quality, affordability and equity of employer-sponsored healthcare. We’ll learn how Morgan Health evaluates the employer market, where they’re placing investment bets, and how they are testing new care models inside JPMorgan’s own benefit. We then turn to Washington: Dan shares his take on the policy currents that matter most for employers and innovators over the next few years.

• Dan Mendelson, CEO, Morgan Health
• LinkedIn
• Forbes Contributions
• Avalere Health
• Balanced Budget Act of 1997
• Jamie Dimon, Chairman and CEO of JPMorgan Chase & Co.
• Continuation of Health Coverage (COBRA)
• Vera Whole Health, Central Ohio Primary Care
• Centivo
• Embold Health
• Cigna Healthcare
• Quantum Health
• Thyme Care
• 60 Minutes, “$2 million gene therapy could save her baby’s life. But insurance wouldn’t pay”
• PBM Alternatives
• Pharmacy Benefit Managers (PBMs)
• Individual Coverage Healthcare Reimbursement Accounts (ICHRA)

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The FDA’s Accelerated Approval Program (AAP) aims to bring promising, potentially life-saving medicines to patients sooner by allowing approvals based on surrogate endpoints while requiring timely confirmatory evidence. In this episode, we speak with Bridget Doherty, MPH, MS (Johnson & Johnson Innovative Medicine), and Jeff Allen, PhD (Friends of Cancer Research). Bridget discusses her team’s review of the AAP’s real-world impact, showing that hundreds of thousands of meaningful life-years have been gained for patients. Jeff shares findings from work strengthening biomarkers as reliable surrogate endpoints—helping define when increased speed can still preserve scientific rigor. We also explore the core access challenge: how payer coverage and utilization management help or hinder patients the AAP is designed to serve. We close with practical policy steps to ensure that earlier regulatory access truly leads to better outcomes for people who need treatments most.

• Bridget Doherty, MPH, MS, Johnson & Johnson

• Jeff Allen, Friends of Cancer Research

• J&J Center for U.S. Healthcare Policy Research

• Friends of Cancer Research

• Accelerated Approvals in Oncology Tracker

• Drug Development Dashboards

• 30 Years of Accelerated Approval: Data-Driven Insights

• Analysis of FDA Biomarker Qualification Program

• Original JNCCN Study

• How Gleevec Transformed Leukemia Treatment

• Immunotherapy

• Surrogate Endpoints

• Confirmatory Trials

• Years Gained from the FDA Accelerated Approval Program (2024)

• Circulating Tumor DNA (ctDNA)

• ctMoniTR Project

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
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