OBJECTIVE
GLP‑1 drugs drive significant growth in Part D spending, with over 4 million enrollees using these drugs and net spending totaling $14 billion in 2024. Stakeholders have raised concerns that vertical integration may create financial incentives to overdispense prescriptions. By allowing health plans to pay their own pharmacies for dispensed drugs, plans can increase profits through price markups and shift revenue away from their closely regulated health plans—where profits are limited—to their pharmacy operations which are not subject to the same restrictions. This may contribute to drug waste and higher Part D spending. In 2024, 79 percent of individuals enrolled in Part D were in a plan offered by a vertically integrated sponsor, giving these organizations potential influence on spending and use patterns. Building on prior work examining the impacts of vertical integration in Part D, this study will assess overdispensing of GLP‑1 drugs and compare GLP‑1 use and spending between vertically integrated and non‑vertically integrated entities.
TIMELINE
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September 15, 2026Announced