This legislation mandates the Comptroller General of the United States (GAO) to conduct a comprehensive study on price-related compensation and payment structures within the retail prescription drug supply chain. The study will investigate how various intermediaries, including pharmacy benefit managers, Part D plan sponsors, drug wholesalers, pharmacies, and manufacturers, utilize drug prices to determine fees and payments. The GAO's investigation will detail the type, magnitude, and prevalence of these compensation structures, such as fees calculated as a percentage of a drug's price, and analyze the primary business models for each intermediary. It will also examine variations between affiliated and unaffiliated entities and identify potential conflicts of interest , particularly how price-based fees might incentivize the selection of higher-priced drugs. The study is further tasked with analyzing patterns and trends in these compensation structures over time and across different market segments, such as Medicare Part D and Medicaid, along with the factors driving their use. Within two years of enactment, the Comptroller General must submit a detailed report to Congress, presenting the study's findings and offering recommendations for appropriate legislative and administrative actions.