Drug Stores & Pharmacies
Industry Profile Report
Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters
Industry Overview Current Conditions, Industry Structure, How Firms Operate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.
Call Preparation Call Prep Questions, Industry Terms, and Weblinks.
Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.
Industry Profile Excerpts
Industry Overview
The 19,300 drug store and pharmacy firms in the US are the primary channel for selling prescription drugs. Mail order pharmacies typically sell only prescription drugs, while retail drug stores usually market a large number of other drug and non-drug products, and may offer several healthcare-related services. Both retail drug stores and mail order pharmacies may act as Prescription Benefit Managers (PBMs), designing and administering prescription drug benefit plans on behalf of private employers, unions, insurance companies and other benefit plan providers.
Reduction in Prescription Drug Reimbursement
Sales of prescription drugs reimbursed by third party payers, including the Medicare Part D plans and state sponsored Medicaid agencies, typically represent over 95% of drug store and pharmacy prescription revenues.
Increased Government Regulation
Prescription drug pharmacies are subject to rapidly changing and increasingly complex government regulations at the federal, state and local levels.
Industry size & Structure
The average drug store and pharmacy employs 16-17 workers and generates $15-16 million in annual revenue.
- The drug store and pharmacy industry is comprised of about 19,300 retail or mail order pharmacy firms that operate over 44,000 stores, generating $301 billion in revenue, and employing 725,000 people.
- About 39% of stores have less than 20 employees, and 29% have fewer than 10 employees.
- Three large chains dominate the retail drug store segment (CVS Caremark, Walgreens, and RiteAid).
- Express Scripts dominates the mail order segment.
Industry Forecast
Drug Stores & Pharmacies Industry Growth
Recent Developments
Nov 4, 2024 - Medicare Part D Payment Updates Finalized
- Annual out-of-pocket costs for the Medicare Part D drug benefit will be capped at $2,000 in 2025, according to the Centers for Medicare & Medicaid Services (CMS). Many insurers are increasing premiums for their stand-alone drug plan offerings, however, according to health policy research firm KFF. Some major plan sponsors, including Aetna and UnitedHealthcare, are also reducing their stand-alone prescription drug plan offerings, and overall, there will be fewer prescription drug plans in 2025 than in 2024 – 524 plans nationwide, down from 709 in 2024.
- The Biden administration reached an agreement with drugmakers to lower prices on the 10 costliest prescription drugs under Medicare beginning in 2026. The agreement with drugmakers is projected to save older adults $1.5 billion in out-of-pocket costs when the new prices go into effect in 2026. The drugs are purchased through Medicare Part D, a prescription drug coverage program for Americans who are 65 and older. The 10 medications were used by 9 million patients with Medicare coverage in 2023 and accounted for $56.2 billion in total Medicare spending. The government estimates that, had the negotiated prices been in place that year, Medicare would have saved about $6 billion. Total annual spending on prescription drugs in the US exceeds $405 billion, and Part D alone accounts for more than $215 billion.
- Strong pre-pandemic store growth is reversing as the industry faces headwinds like falling prescription reimbursement, persistent theft, and changing shopping habits, according to the Associated Press (AP). A pattern to who has access to pharmacies has emerged, with gaps existing in urban and rural neighborhoods. Residents of neighborhoods that are largely Black and Latino have fewer pharmacies per capita than people who live in mostly white neighborhoods, according to an AP analysis of licensing data from 44 states, data from the National Council for Prescription Drug Programs, and the American Community Survey. Drug stores and pharmacies routinely close because they aren’t doing well financially or because of decreasing population in a service area, according to the AP. More than 7,000 US pharmacies have closed since 2019, according to data from University of Pittsburgh researcher Lucas Berenbrok, who considers that estimate conservative. About 54% of the closures were independent drugstores, an AP analysis of Berenbrok’s data found.
- Drug store and pharmacy sales decreased 2.6% year over year and 5.2% month over month in June 2024, according to the US Census Bureau. The prices that drug stores and pharmacies charge for their products decreased slightly during the first nine months of 2024, according to the US Bureau of Labor Statistics (BLS). Consumer spending, an indicator of drug store and pharmacy sales, increased 2.6% year over year and 0.2% month over month in June 2024, according to the US Bureau of Economic Analysis. Drug store and pharmacy employment decreased slightly while wages for nonsupervisory employees increased slightly during the first nine months of 2024 , according to the BLS.
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