Prescription Drug Trade-Off: Lower Premiums, Higher Out-of-Pocket Costs in Vertical Integration

Patients without extra financial help paid nearly 40 percent more in out-of-pocket costs in vertically integrated plans, the federal audit found.

A pharmacy manager works in the new Amazon pharmacy, adjacent to a fulfillment center, in Corona, Calif., on May 29, 2024. Terry Pierson/The Orange County Register via AP

A pharmacy manager works in the new Amazon pharmacy, adjacent to a fulfillment center, in Corona, Calif., on May 29, 2024. Terry Pierson/The Orange County Register via AP

Ownership of the prescription drug supply chain by a single large company can lower insurance premiums for consumers but leads to higher out-of-pocket costs for many, according to a May 2026 audit report. 

The audit conducted by the Office of Inspector General for the Department of Health and Human Services studied the impact of “vertical integration” on prescription drug costs for the Medicare Part D program.