
NCPA Says HHS OIG Report Raises Important Questions
Key Takeaways
- Vertically integrated health plans are linked to substantially higher beneficiary out-of-pocket drug spending, consistent with concerns that common ownership creates incentives misaligned with affordability.
- Data limitations in pharmacy payments restrict the ability to quantify full vertical-integration impacts, leaving critical uncertainty regarding reimbursement flows and effects on community pharmacies.
Regulators and policymakers can’t understand the effect of vertically integrated insurance plans without full transparency, say independent pharmacists.
ALEXANDRIA, Va. (May 21, 2026) – The National Community Pharmacists Association issued the following statement today on behalf of CEO B. Douglas Hoey in response to
“The OIG’s report reveals several key takeaways, including that patients covered by vertically integrated health plans pay substantially higher drug out of pocket costs. In comments to the Federal Trade Commission, NCPA has highlighted the unholy trinity of health plans, pharmacy benefit manager (PBM) and affiliated pharmacy under one ownership, making health care less affordable due to the conflicts of interest inherent in common ownership.
“Another key takeaway is that vertically integrated health insurance corporations continue to, at best, make it difficult to analyze the full cost impact on purchasers of health care. The OIG highlighted ‘data limitations pertaining to pharmacy payments’ that made the full impacts of vertical integration on pharmacies unknown. What is known is that the vertically integrated health plans/PBMs make it difficult even for the FTC to investigate their impact on consumers and competition. The FTC has indicated that PBM practices remain highly opaque, requiring required multiple rounds of compulsory data requests in their efforts to investigate the impact of PBMs.
“The OIG study also noted that just six health plans account for over 80 percent of all of the gross Part D spending in 2023. That level of market concentration is consistent with findings from previous reports by the FTC, the House Oversight Committee, and several news investigations, all of which determined that PBMs increase the cost of drugs and limit patient choice.
“We look forward to future OIG findings as they continue this important work, and we look forward to their ongoing efforts to complete the blind spots in the report due to limitations in data provided by the health care conglomerates.”


























































































































