The U.S. Department of Health and Human Services' Office of the Inspector General (HHS OIG) announced that it is conducting an audit of vertically integrated Medicare Part D sponsors. Results of this audit are expected to be published during fiscal year 2026. In its announcement, HHS OIG commented that, in recent years, the pharmaceutical industry has experienced a wave of vertical integration between PBMs, health insurers, and pharmacies. HHS noted growing concern about the vertically integrated model, namely that through vertical integration and subsequent ownership of many links in the supply chain, a vertically integrated Medicare Part D sponsor may inflate drug prices. HHS OIG hopes to determine the impact of such vertically integrated entities on the prices for covered Part D drugs.
NCPA
