Drug and Druggists' Sundries Wholesalers NAICS 424210
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Industry Summary
The 7,012 Drug and druggists’ sundries wholesalers in the US distribute biological and medical products; botanical drugs and herbs; pharmaceutical products; and related goods. Prescription drugs account for over 80% of industry sales. Other product categories include cosmetics and beauty supplies; vitamins and nutritional supplements; non-prescription drugs; and personal care items.
Regulated Environment
The distribution, compounding, purchase, and storage of pharmaceuticals is highly regulated by the Drug Enforcement Administration (DEA), FDA, and US Department of Health and Human Services (HHS).
Reimbursement Rates and Coverage
The drug wholesale industry is affected by changes to medical reimbursement rates, which continue to fall as the healthcare industry looks for ways to cut costs.
Recent Developments
Feb 22, 2026 - Trump Administration's Tariffs Struck Down By US Supreme Court
- The US Supreme Court ruled in late February 2026 that President Trump exceeded his authority when imposing tariffs using a law reserved for a national emergency. The decision only invalidates tariffs implemented using a 1977 law called the International Emergency Economic Powers Act (IEEPA). IEEPA tariffs represent about half of the import taxes that the government is collecting each month, according to National Public Radio. Drug and druggists' sundries wholesalers are likely to benefit if the cost of goods imported from countries that were hit with tariffs decreases. The Trump administration can use other laws to impose duties on goods from other countries, however, and President Trump issued an executive order shortly after the Supreme Court ruling that implements a new tariff under Section 122 of the 1974 Trade Act. Section 122 allows the president to institute a "temporary import surcharge" of up to 15% if he finds there are "large and serious United States balance of-payments deficits" or to "prevent an imminent and significant depreciation of the [US] dollar in foreign exchange markets." The tariffs can last for up to 150 days, after which Congress may have to take action to extend them, according to NBC News, and the law is also not clear on whether the administration could restart the tariffs immediately after the 150 days with another executive order. The new tariff will result in a major decrease to tariffs applied to most key trading partners, according to NBC News. Trade Representative Jamieson Greer said, however that the administration would also open Section 301 investigations on "most major trading partners" on an "accelerated timeframe." The investigations could allow the administration to impose tariffs under that section of the 1974 law if it finds that "the rights of the US are being denied under any trade agreement," or whether any trade agreement is "unjustifiable and burdens or restricts United States commerce." Other approaches to tariffs also remain available: The Trump administration has already used Section 232 of the 1962 Trade Expansion Act to impose tariffs on goods determined to be a national security threat. Section 232 has been applied it to goods ranging from aluminum to bathroom vanities, according to Business Insider.
- The three largest US pharmaceutical wholesalers — Cardinal Health, Cencora, and McKesson — are using vertical integration to strengthen their positions in the buy-and-bill market for provider-administered drugs, according to Gene Online. Wholesalers are expanding their influence beyond traditional drug distribution by integrating with downstream customers and acquiring stakes in practice management companies. Private equity roll-ups have played a key roll in providing wholesalers with opportunities to acquire ownership stakes in practice management firms.
- President Trump said during a meeting with pharmaceutical and technology industry executives that companies which move their operations to plants in the US would face no tariffs, according to The Guardian. He also suggested that companies would have the time needed to repatriate some manufacturing with new or expanded operations in the US before they would face a “tariff wall”. President Trump paused his “reciprocal” tariffs for 90 days after they prompted a sell-off of US government bonds in April but he has repeatedly threatened to carry through with sectoral tariffs on the pharmaceutical industry.
- Drug and druggist’s sundries wholesaler industry employment and average wages for nonsupervisory employees increased slightly during the first eight months of 2025, according to the US Bureau of Labor Statistics (BLS). Drug and druggist’s sundries wholesalers slightly increased their prices during the first nine months of 2025, according to the BLS.
Industry Revenue
Drug and Druggists' Sundries Wholesalers
Industry Structure
Industry size & Structure
The average drug wholesaler operates out of a single location, employs 44 workers, and generates about $187 million annually.
- The drug and druggists' sundries wholesale industry consists of about 7,012 firms that employ about 311,580 workers and generate $1.3 trillion annually.
- The industry is concentrated; the top 50 companies account for 89% of industry revenue.
- Large companies include McKesson, Amerisource Bergen, Cardinal Health, and JM Smith. Large firms may have international or pharmacy retail operations.
Industry Forecast
Industry Forecast
Drug and Druggists' Sundries Wholesalers Industry Growth
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