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
Sep 2, 2025 - Federal Appeals Court Rules Against Trump Administration Tariffs
- The US Court of Appeals for the Federal Circuit has ruled that President Trump overstepped his authority when he declared national emergencies to justify tariffs on many countries. Drug and druggists’ sundries wholesalers are likely to benefit if the cost of goods imported from countries that were hit with tariffs decrease. US law “bestows significant authority on the president to undertake a number of actions in response to a declared national emergency, but none of these actions explicitly include the power to impose tariffs, duties, or the like, or the power to tax”, the court said in the 7-4 ruling. Many of President Trump’s steep tariffs are “unbounded in scope, amount and duration”, the ruling added, and “assert an expansive authority that is beyond the express limitations” of the law his administration has cited. The court said that the ruling would not take effect until October 14. The Trump administration is expected to appeal the ruling to the US Supreme Court.
- 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 five months of 2025, according to the US Bureau of Labor Statistics (BLS). Drug and druggist’s sundries wholesalers slightly decreased their prices during the first half 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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