Medicare Part D: Payments and Contracts Between Pharmacies and Plan Sponsors That Are Vertically Integrated [Reissued with revisions on Oct. 6, 2026]
What GAO Found The insurance plan sponsors that provide Medicare Part D drug coverage have increasingly become vertically integrated—that is, under common ownership—with pharmacy benefit managers and pharmacies. GAO found that, for four large Part D plan sponsors, the pharmacies they owned accounted for about 28 percent of the Part D drugs they provided to their enrollees (drug utilization) and about 24 percent of the total payments to pharmacies in 2023 (see figure). Payments included both reimbursement from plan sponsors and cost sharing paid by or on behalf of beneficiaries. When these vertically integrated plan sponsors’ own pharmacies provided drugs to their enrollees, they primarily d.
Reported by Maria LopezMedicare Part D: Payments and Contracts Between Pharmacies and Plan Sponsors That Are Vertically Integrated [Reissued with revisions on Oct. 6, 2026].
The item is dated Tue, 06 Oct 2026 14:40:52 -0400.
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What GAO Found The insurance plan sponsors that provide Medicare Part D drug coverage have increasingly become vertically integrated—that is, under common ownership—with pharmacy benefit managers and pharmacies.
GAO found that, for four large Part D plan sponsors, the pharmacies they owned accounted for about 28 percent of the Part D drugs they provided to their enrollees (drug utilization) and about 24 percent of the total payments to pharmacies in 2023 (see figure).
Payments included both reimbursement from plan sponsors and cost sharing paid by or on behalf of beneficiaries.
When these vertically integrated plan sponsors’ own pharmacies provided drugs to their enrollees, they primarily d…
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GAO reports and testimonies RSS. Accessed 2026-10-07T15:00:04.091Z.