Drug Channels delivers timely analysis and provocative opinions from Adam J. Fein, Ph.D., the country's foremost expert on pharmaceutical economics and the drug distribution system. Drug Channels reaches an engaged, loyal and growing audience of more than 100,000 subscribers and followers. Learn more...
This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: What’s Next for Retail Pharmacy: Data, Debate, and Disruption. I’ll be joined by special guest Antonio Ciaccia, CEO of 46brooklyn Research, and President of 3 Axis Advisors.
Drug Channels Institute’s (DCI’s) latest analysis reveals that PBM-affiliated specialty pharmacies continue to dominate the dispensing of specialty drugs.
DCI has identified nearly 1,900 dispensing locations with specialty pharmacy accreditation. Below, we share DCI’s latest analysis of the top 15 specialty pharmacies, including updated market shares and revenue estimates.
As in prior years, pharmacies linked to the three largest pharmacy benefit managers (PBMs) accounted for two-thirds of prescription revenues from pharmacy-dispensed specialty drugs. We also explore how these pharmacies contribute to PBMs’ profitability—and spotlight the growing influence of provider- and health system-owned dispensing channels.
Once again, “specialty” mostly means affiliated with a PBM.
This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: What’s Next for Retail Pharmacy: Data, Debate, and Disruption. I’ll be joined by special guest Antonio Ciaccia, CEO of 46brooklyn Research, and President of 3 Axis Advisors.
Three’s still company in the world of pharmacy benefit managers.
For 2024, nearly 80% of all equivalent prescription claims were processed by three familiar companies: the CVS Caremark business of CVS Health, the Express Scripts business of Cigna, and the Optum Rx business of UnitedHealth Group. The names haven’t changed, but shifting relationships and contract shakeups have altered the plot, with Express Scripts stepping into a new lead role.
Below, we break down the latest market share data from Drug Channels Institute (DCI), explore the developments driving these changes, and examine what they signal for the future of the PBM landscape.
This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: What’s Next for Retail Pharmacy: Data, Debate, and Disruption. I’ll be joined by special guest Antonio Ciaccia, CEO of 46brooklyn Research, and President of 3 Axis Advisors.
For 2024, DCI estimates that total prescription dispensing revenues at retail, mail, long-term care, and specialty pharmacies reached $683 billion, up 9% from the 2023 figure. GLP-1 agonist drugs remained the most significant driver of prescription revenue at retail pharmacies, accounting for more than 80% of dispensing revenue growth for 2024.
The table below—one of 268 in our new report—cues up DCI's first look at the 15 largest organizations that battled for those revenues. For a sneak peek at the complete report, click here to download our free 30-page report overview (including key industry trends, What's New in this edition, the Table of Contents, and a List of Exhibits).
Today’s guest post comes from Sean Wagner, VP of Client Partnerships and Carolyn Zele, Advisor, Solution Consulting at MMIT.
Sean and Carolyn argue that planning for a successful drug launch must begin early—often well before Phase III. In this article, they present a six-step framework to help manufacturers align clinical development with payer expectations, patient needs, and real-world access dynamics.
The 340B Drug Pricing Program has emerged as a growing source of profits for pharmacies and pharmacy benefit managers (PBMs).
Drug Channels Institute’s latest exclusive analysis of the 2025 market reveals a highly concentrated market structure increasingly dominated by a handful of major players:
About 32,000 pharmacy locations—nearly 60% of the entire U.S. pharmacy industry—function as contract pharmacies for the hospitals and federal grantees that participate in the 340B program.
The 340B contract pharmacy has become increasingly concentrated with five multi-billion-dollar, for-profit, publicly traded pharmacy chains and pharmacy benefit managers (PBMs)—Cigna (via Express Scripts), CVS Health, UnitedHealth Group (via Optum Rx), Walgreens, and Walmart.
Today’s guest post comes from Logan Melchione, VP of Patient Affordability at Paysign.
Logan explores how maximizers have reshaped the patient affordability landscape and pressured pharmaceutical manufacturers to adapt their copay strategies. In this guest post, she outlines her perspective on the limitations of traditional copay solutions, describes Paysign’s data-driven approach to first-fill identification of maximizer impact, and shares how the company reports saving millions while improving patient access.
To request an analysis of your program’s maximizer exposure risk and learn more about Paysign solutions, email affordability@paysign.com or visit paysign.com/rx.
It’s time for Drug Channels’ annual look at pharmacist salaries and employment.
There was more bad news, as employment in retail pharmacies and drugstores dropped by 8,500 positions in 2024, following a drop of 4,800 positions in 2023. Employment in mass merchants and supermarkets with pharmacies increased. Meanwhile, employment at hospitals surged to a new high, growing by nearly 7,000 positions in 2024.
Average salaries hit $137,000, but varied widely across practice settings. However, salary growth did not keep pace with overall inflation.
Get ready for the future of pharmacy on June 20, 2025 (12:00–1:30 p.m. ET). Dr. Adam J. Fein and Antonio Ciaccia will unpack the good, the bad, and the ugly of the pharmacy industry—and explore what it means for you. This dynamic session will blend expert insights and real-time debate. Click here to register.
To sign up for the webinar or enter into a direct agreement with GoodRx, pharmacies are not waiving their rights to participate in ongoing litigation against GoodRx. Pharmacies are not required to agree to GoodRx's Terms of Use in order to sign up for the webinar.
Don’t miss DCI’s June 20, 2025, webinar, featuring Dr. Adam J. Fein and Antonio Ciaccia. We’ll unpack the good, the bad, and the ugly of the pharmacy industry—and explore what it means for you. This dynamic session will blend expert insights and real-time debate. Join us!
The Inflation Reduction Act (IRA) is triggering increases in Medicare beneficiaries’ spending on their Part B drugs.
Though CMS touts that the IRA’s inflation-based coinsurance adjustments will "lower out-of-pocket costs," the results have been more complicated. Below, we update and expand on our previous analysis.
We find that a growing number of Part B drugs now have inflation-adjusted coinsurance rates that are rising, not falling. In many cases, the rate dips temporarily before snapping back to the standard 20%.
Even more troubling, these fluctuations have led to unexpected increases in patients’ out-of-pocket expenses—even when a drug’s price was declining.
These unpredictable coinsurance shifts are another example of the IRA’s unintended consequences. Rather than enjoying stable or reduced costs, some seniors are finding themselves on a financial rollercoaster.
Don’t miss DCI’s next webinar on June 20, 2025 (12:00–1:30 p.m. ET), featuring Dr. Adam J. Fein and Antonio Ciaccia. We’ll unpack the good, the bad, and the ugly of the pharmacy industry—and explore what it means for you. This dynamic session will blend expert insights and real-time debate. Hope you can join us!
Dr. Adam J. Fein, president of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for DCI’s new live video webinar:
This event will be broadcast live on:
Friday, June 20, 2025
12:00 p.m. to 1:30 p.m. ET
Dr. Fein will be joined by special guest Antonio Ciaccia, CEO of 46brooklyn Research, and President of 3 Axis Advisors. Adam and Antonio will share their unique insights on the pharmacy market and engage in a dynamic, real-time debate you won’t want to miss!
Join industry experts Adam and Antonio for an exclusive deep dive and discussion into the latest trends, data, and strategies shaping the retail pharmacy industry. Drawing from their organizations’ respective research, they will provide invaluable insights to help you and your team stay informed about this rapidly changing marketplace.
Topics will include:
The competitive landscape of retail pharmacy, with exclusive market data from DCI and 46brooklyn
Key economic trends among leading PBMs and their impact on the market
PBMs’ controversial effect on pharmacy and how they’re shaping the industry
The medications driving pharmacy profits and the ones bringing financial pain
The benefits and shortcomings of state and federal PBM regulations, including a debate over the new Arkansas law
Exclusive insights into the latest state transparency reports
The complex roles of pharmaceutical wholesalers in pharmacies’ supply chain
The risks and rewards of acquisition cost pharmacy reimbursement
The pros and cons of the 340B Drug Pricing Program for retail pharmacies
How hospital-owned pharmacies are changing the game
The outlook for shakeout and consolidation
Actionable takeaways for pharmaceutical manufacturers and pharmacy leaders
Emerging controversies, challenges, and threats to watch in the industry
And much more!
As always, Adam and Antonio will clearly distinguish their opinions and interpretations from the objective facts and data.
What’s more, this 90-minute video webinar will feature a live discussion and debate between Adam and Antonio. Watch these two experts challenge conventional wisdom—and each other—in an unprecedented throwdown.
Register now to stay informed and get ahead of the curve on the pharmacy industry!
PRICING OPTIONS
Take advantage of this exclusive educational opportunity for just $420 per viewing device. Once you register, you'll receive a unique Zoom access link within 24 hours—making it easy to add the event to your calendar and ensure you don’t miss out.
Special Discounts For Teams!
We understand that many professionals are working remotely, so we’re offering substantial savings for multiple registrations from the same organization:
Register multiple devices for as low as $295 each—a 30% discount!
Unlimited attendees can watch together at a single physical location (one registered device required).
Important Reminder: Each device at a single physical location must have its own registration. The webinar may not be recorded, streamed, broadcast, or shared across different locations, devices, or sites.
Click here to order. All discounts will be automatically computed based on the number of registrations you enter in your cart. (You can reset the cart by entering 0 in the quantity field.)
Payment can be made with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Need to pay via check or ACH? Click here to request an invoice.
IMPORTANT THINGS TO KNOW
Watch and listen via any device with a web browser (computer, iPad, iPhone/Android, etc.) There is no access via telephone.
We will use Zoom technology for this webinar. Every registrant will receive an email from Zoom with a link to watch the event. This link is unique to the registrant and can only be accessed once. We recommend that every registrant download the Zoom client software/app.
Every registrant will receive an email from Zoom with links to download Adam and Antonio’s slides.
The day after the event, every registrant—whether they attended the live event or not—will receive an email from Zoom with information on how to access a video replay of the live event and download all slides.
This event is part of The Drug Channels 2025 Video Webinar Series. If you already purchased access to the 2025 Drug Channels Video Webinar Series, then you should have received an email from Zoom with a link to access the June 20, 2025, event.
Organizations that purchased corporate access for The Drug Channels 2025 Video Webinar Series will receive a custom, branded signup link so employees can easily register. We will automatically refund payments from anyone at a company with corporate access who purchases a single registration using their corporate email account.
Each registration for a DCI webinar is valid for a single device at a single physical location. Each device at a physical location requires its own registration. Attendees are not permitted to record, stream, share, or project a DCI webinar to other sites or locations. Purchasers who violate this limitation by recording, streaming, sharing, or projecting a DCI webinar to other sites, devices, or locations will be liable for the full cost of all locations that viewed the webinar. DCI reserves the right to prohibit purchasers who violate our terms from attending future DCI webinars.
Today’s guest post is from Divya Iyer, SVP of Go-to-Market Strategy at GoodRx.
Divya shares new GoodRx data showing that out-of-pocket costs at the pharmacy counter remain a primary barrier to medication adherence. Despite the availability of manufacturer-sponsored support programs, many patients still abandon their prescriptions due to high costs.
This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: 
This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: 
