{"id":391957,"date":"2026-04-14T18:10:13","date_gmt":"2026-04-14T18:10:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/391957\/"},"modified":"2026-04-14T18:10:13","modified_gmt":"2026-04-14T18:10:13","slug":"drug-channels-mapping-the-vertical-integration-of-insurers-pbms-gpos-specialty-pharmacies-and-healthcare-services-dcis-2026-update","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/391957\/","title":{"rendered":"Drug Channels: Mapping the Vertical Integration of Insurers, PBMs, GPOs, Specialty Pharmacies, and Healthcare Services: DCI\u2019s 2026 Update"},"content":{"rendered":"

\"\"<\/a>It’s time for Drug Channels Institute\u2019s (DCI) annual update of vertical integration among insurers, PBMs, specialty pharmacies, and healthcare services within U.S. drug channels. As you can see below, we have updated and revised our infamous illustration of the major vertical business relationships within the largest companies.<\/p>\n

These organizations continue to exert greater control over patient access, sites of care\/dispensing, and pricing, although some have started to unwind their vertical integration strategies. Scrutiny of these companies\u2019 actions continues to grow.\n<\/p>\n

For all the details behind these companies\u2019 operations, check out DCI\u2019s new 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers<\/a>.

\n
The chart below provides an updated illustration of the major vertical business relationships among insurers, PBMs, specialty pharmacies, healthcare services, and other companies within U.S. drug channels. The companies are listed alphabetically by insurer name.\n<\/p>\n

[Click to Enlarge]<\/p>\n

\"\"<\/a>
\nThis chart appears as Exhibit 267 in the\u00a02026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers<\/a>.<\/p>\n

Section 12.3.1. of the report reviews the transactions that created these companies and explains the incentives for\u2014and potential competitive challenges from\u2014vertical integration. Throughout the 2026 report, we analyze the various businesses within these organizations:\n<\/p>\n

Pharmacy benefit managers (Section 5.2.2.)
\nRetail pharmacies (Section 2.3.3.)
\nSpecialty pharmacies (Section 3.3.2.)
\nGroup purchasing organizations (Section 5.2.4.)
\nPrivate label products (Section 5.2.5.)
\nHealthcare providers (Section 1.4.1.)
\nHere are some notable changes from last year\u2019s edition:
\nAffiliated third-party administrators (TPAs) and administrative services only (ASO) platforms are included within the \u201cInsurer\u201d category. Most large employers self-fund their health benefits and contract with these affiliated ASO\/TPA platforms for claims administration and network access. Although these entities do not assume underwriting risk, they serve as the primary gateway to employer-sponsored lives and can channel volume to vertically integrated subsidiaries.
\nBusinesses that work with hospitals and health systems to provide specialty pharmacy services are included within specialty pharmacy. Health systems and hospitals have emerged as the fastest-growing direct participants in the specialty pharmacy market by operating internal pharmacies. They account for nearly one-third of all specialty pharmacy locations accredited by ACHC or URAC. Changes in manufacturers\u2019 340B contract pharmacy policies have accelerated hospitals\u2019 investments in in-house specialty pharmacy operations.<\/p>\n

As we discussed in last month\u2019s news roundup<\/a>, The Cigna Group\u2019s Evernorth Health Services now owns 100% of CarepathRx<\/a>, which assists hospitals and health systems with specialty pharmacy operations. In 2025, Evernorth also invested $3.5 billion for an undisclosed stake in Shields Health Solutions<\/a>, the former Walgreens Boots Alliance subsidiary with a similar hospital-focused specialty pharmacy model.\n<\/p>\n

In 2024, UnitedHealth Group acquired CPS Solutions<\/a>, which also offers specialty pharmacy services to hospitals and health systems. <\/p>\n

Businesses that have been sold off have been removed. For example, Centene began outsourcing PBM operations to Express Scripts in 2024. It has also sold various other businesses, including the Magellan Rx PBM, PANTHERx Rare specialty pharmacy, the Magellan Specialty Health benefit management company, and a majority stake in its U.S. Medical Management physician home health business. In 2025, Cigna quietly sold its Evernorth Care Group, which had operated 18 primary care clinics, to HonorHealth.
\nAs vertical integration evolves\u2014and in some cases unwinds\u2014these interconnections remain essential to understanding how drugs flow through the channel, where profits accumulate, and how we all experience the U.S. healthcare system. <\/p>\n

We\u2019ll be back in 2027 with another update\u2014 assuming the industry or Congress doesn\u2019t reorganize everything first.<\/p>\n","protected":false},"excerpt":{"rendered":"It’s time for Drug Channels Institute\u2019s (DCI) annual update of vertical integration among insurers, PBMs, specialty pharmacies, and…\n","protected":false},"author":2,"featured_media":391958,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[163,521,85,46],"class_list":["post-391957","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-health","tag-healthcare","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/391957","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=391957"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/391957\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/391958"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=391957"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=391957"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=391957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}