{"id":390653,"date":"2026-04-21T15:54:15","date_gmt":"2026-04-21T15:54:15","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/390653\/"},"modified":"2026-04-21T15:54:15","modified_gmt":"2026-04-21T15:54:15","slug":"pbm-affiliated-pharmacies-dominate-while-health-systems-and-independents-gain-ground","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/390653\/","title":{"rendered":"PBM-Affiliated Pharmacies Dominate While Health Systems and Independents Gain Ground"},"content":{"rendered":"

By Adam J. Fein, Ph.D.<\/a>\"\"<\/a>Drug Channels Institute\u2019s (DCI\u2019s) latest analysis reveals that PBM-affiliated specialty pharmacies continue to dominate the dispensing of specialty drugs. <\/p>\n

For 2025, DCI has identified more than 1,900 dispensing locations with specialty pharmacy accreditation from one or both of the two major independent accreditation organizations. The overall number of accredited locations grew by only 3% in 2025, but is more than five times larger than the 2015 figure.<\/p>\n

However, market share for the dispensing of specialty drugs remains highly concentrated. For 2025, the three largest specialty pharmacies accounted for two-thirds of total prescription revenues from pharmacy-dispensed specialty drugs. These businesses are all owned by vertically integrated organizations that also own a PBM.<\/p>\n

Below, we share DCI\u2019s latest analysis of the top 15 specialty pharmacies, including updated market shares and revenue estimates, highlighting how vertical integration and channel control continue to reshape specialty dispensing. Despite growth in accredited locations, economic power remains concentrated among a small group of PBM-affiliated entities.<\/p>\n

Next week, the DCI team will be attending Asembia\u2019s AXS26 Summit in fabulous Las Vegas. Please say hello if you see us!

\n
2025 MARKET TRENDS\n<\/p>\n

This post is the fourth installment in a series based on insights from DCI\u2019s new 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers<\/a>.\n<\/p>\n

Here are the earlier articles in the series:
\n<\/p>\n

\nDCI\u2019S DATA AND OBSERVATIONS ON SPECIALTY DISPENSING<\/p>\n

In 2025, retail, mail, long-term care, and specialty pharmacies collectively dispensed an estimated $293.4 billion in specialty pharmaceuticals\u2014a 9.6% increase over the revised 2024 figure.<\/p>\n

The chart, which appears as Exhibit 56 in our 2026 pharmacy\/PBM report<\/a>, ranks the top pharmacies by estimated dispensing revenues from specialty pharmaceuticals. The figures include all dispensing formats of the respective businesses. We cover many of the individual companies listed below in the subsections of the report\u2019s Section 3.3.\n<\/p>\n

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

\"\"<\/a>
\n
Our observations on today\u2019s marketplace:<\/p>\n

A small number of independent specialty pharmacies are emerging as the winners. Taken together, the developments above are challenging independent specialty pharmacies. While independents remained the single largest category of accredited locations in 2025, they account for a minority of total specialty dispensing revenues.<\/p>\n

However, the fastest-growing independent players are larger, well-capitalized, and growing quickly. For example, the three independent specialty pharmacies shown above\u2014PANTHERx Rare, Senderra Specialty Pharmacy, and Soleo Health\u2014have all received substantial investments from private equity firms. <\/p>\n

Some smaller, independent specialty pharmacies also remain well-represented in manufacturers\u2019 exclusive specialty pharmacy networks. By contrast, PBM-affiliated specialty pharmacies only have access to 20% of specialty products with exclusive dispensing networks. <\/p>\n

Specialty drugs accounted for less than 40% of the pharmacy industry\u2019s prescription revenues in 2025, although their share has plateaued in recent years. Specialty drugs\u2019 share of plan sponsors\u2019 pharmacy benefit costs is higher than their share of prescription revenues, because rebates do not impact prescription dispensing revenues.<\/p>\n

Taken together, DCI\u2019s latest report illustrates a bifurcating market: scale and integration drive dominance at the top, while selective access and manufacturer relationships sustain a narrower set of independent winners.<\/p>\n

NOTES FOR NERDS
\n<\/p>\n

Most companies do not report prescription revenues from specialty drugs. DCI has therefore used various methods and primary sources to estimate the data. In some cases, the companies provided us with revenue figures. Certain data have been updated based upon new disclosures since the 2025 edition of our report.
\nThe figures include all dispensing formats of the respective businesses. For example, the figure for Walgreens includes Walgreens Specialty Pharmacy (formerly known as AllianceRx Walgreens Pharmacy), Walgreens specialty pharmacy locations inside hospitals, the Walgreens retail specialty pharmacies, and specialty drugs dispensed within Walgreens retail drugstores.
\nAs noted in the exhibit\u2019s footnotes, DCI has made various adjustments to account for the pro forma impact of mergers and acquisitions. Pro forma revenues are computed based on the year in which an acquisition was completed. Year-over-year growth rates were also computed based on the prior year\u2019s pro forma revenues.
\nRevenues in the \u201cAll other retail, mail, long-term care, and specialty pharmacies\u201d category come from the many pharmacies now competing to dispense these expensive therapies. As we discuss in the report\u2019s Chapter 3, the specialty market\u2019s growth continues to draw a diverse set of companies into the business of dispensing specialty drugs.
\nThe market size figure excludes estimated revenues from provider-administered specialty drugs billed under a patient\u2019s medical benefit. <\/p>\n","protected":false},"excerpt":{"rendered":"By Adam J. Fein, Ph.D.Drug Channels Institute\u2019s (DCI\u2019s) latest analysis reveals that PBM-affiliated specialty pharmacies continue to dominate…\n","protected":false},"author":2,"featured_media":390654,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[134,527,111,139,69],"class_list":{"0":"post-390653","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-new-zealand","11":"tag-newzealand","12":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/390653","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=390653"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/390653\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/390654"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=390653"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=390653"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=390653"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}