Preorder Now: DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

On October 14, 2025, Drug Channels Institute will release our 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. This report—our sixteenth edition—is the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.

With 9 chapters, 400+ pages, 187 exhibits, and 850+ endnotes, this report is unmatched in scope and depth. There is no other resource like it.

Preorder today to secure this fully updated, revised, and expanded 2025-26 edition at special discounted prices. Preorders ensure early access. You’ll receive the report before its October 14 release date.

• Download a free 25-page pre-publication report overview—including key industry trends, “What's New,” Table of Contents, and List of Exhibits

• Review pricing/license options and place a preorder

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover). Click here to contact us if you would like to pay by corporate check or ACH.

Special preorder and launch pricing discounts will be valid through October 27, 2025. Act now to maximize savings.

The chart below highlights the three largest companies’ vertical alignment and diverse roles within the U.S. healthcare system. The numbers in the chart indicate the report chapter that corresponds to, explains, and analyzes each business.

[Click to Enlarge]

The 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry. Widely regarded as the industry standard, this encyclopedic resource offers a definitive guide to wholesale distribution’s role in the complex web of U.S. prescription drug channels.

Our 2025-26 edition contains the most current financial and industry data about the distribution of pharmaceuticals and the major companies that handle these products. As always, we have updated all market and industry data with the most current information available. The report also updates our annual analyses of the strategies, market positions, and executive compensation of the three largest companies: Cencora, Cardinal Health, and McKesson.

We review each wholesaler’s business segments and underlying business profitability, based upon our proprietary economic models. This information allows you to assess differences among the public wholesalers’ business organizations, strategies, and financial performance. Where appropriate, financial data have been restated based on updated disclosures.

See pages 9 and 10 of the free report overview for details on the notable new material in this latest edition.

Thank you for your continued interest in our research. Please email me (afein@drugchannels.net) with any questions before purchasing. We look forward to sharing this year’s insights with you.

Inside the 2025 PSAO Market: How Wholesalers Shape Pharmacy–PBM Relationships

Pharmacy services administrative organizations (PSAOs), which operate between pharmacy benefit managers (PBMs) and smaller pharmacies, are among the most mysterious—and misunderstood—intermediaries in our complex U.S. drug channel.

Adding to the mystery: the largest PSAOs are owned by the three multi-billion dollar, public companies that also dominate pharmaceutical distribution—Cencora, Cardinal Health, and McKesson. These companies sit atop the Fortune 500 list and distribute more than 96% of prescription pharmaceuticals in the U.S.

Below, we draw on data from our forthcoming 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors to profile the largest PSAOs and highlight crucial business trends affecting each company. We also examine how wholesalers are leveraging PSAOs as part of a broader vertical integration strategy that is building significant positions in businesses beyond drug distribution. 

So, buckle up and let’s take a trip through the tollbooth to visit yet another overlooked—but powerful—corner of the drug channel.

The $90 Billion Leakage Problem: How RIS Rx Helps Pharma Recover Lost Revenue

Today’s guest post comes from Gerard Rivera, CEO and Co-Founder of RIS Rx.

Gerard explores how pharma companies lose billions each year through copay program inefficiencies, accumulators, maximizers, and other forms of systemic leakage. He introduces RIS Rx, a healthcare technology company whose platform helps manufacturers mitigate gross-to-net (GTN) revenue leakage while supporting patient access and outcomes.

Click here to request a free savings snapshot from the RIS Rx platform for your brand.

Read on for Gerard’s insights.

Inside Rare Disease Pharmacy: Lessons in Personalizing Care

Today’s guest post comes from Bansi Nagji, Chief Executive Officer at PANTHERx Rare.

Bansi explores how the emerging model of “Rare Pharmacy” addresses the challenges rare diseases pose to patients, caregivers, and the healthcare system. His perspective highlights the role of hyper-personalization, empathy, and data in improving outcomes for individuals with rare and orphan conditions, while also pointing to lessons that may extend across the broader healthcare landscape.

Click here to learn more about PANTHERx’s approach to hyper-personalization.

Read on for Bansi’s insights.

Drug Channels Leadership Forum 2026: Full Agenda Now Available (Spoiler: Even more awesome than 2025!)

We’re thrilled to announce the full agenda for the 2026 Drug Channels Leadership Forum (DCLF)—taking place from March 16–18, 2026, at the Turnberry Resort & Spa in Miami. Once again, Drug Channels Institute (DCI) is proud to host this invite-only gathering of senior leaders across the drug channel ecosystem. You must request an invitation to be considered for attendance. We will begin sending invitations in mid-October.

Request Your Invitation

The 2026 program features fireside chats with me, plus dynamic panel discussions led by an exceptional group of executives and subject matter experts. View the full 2026 Drug Channels Leadership Forum agenda.

MEET THE SPEAKERS

Our 2026 lineup brings together a diverse range of C-suite leaders and policy influencers, ensuring every session delivers candid, high-value insights.

WHO SHOULD ATTEND

DCLF is a strategic, invite-only gathering for leaders from across the healthcare and pharmaceutical landscape, including:

• Pharmaceutical manufacturers
• PBMs, health plans, employers, and plan sponsors
• Health systems and physician practices
• Pharmacies and wholesalers
• Policymakers

WHAT TO EXPECT

Expect another year of bold, candid discussions—not just presentations. We’ve enhanced the 2026 agenda with new formats and even more opportunities for direct, high-impact exchanges among attendees.

At DCLF, there are no exhibit halls, no press, no recordings, and no distractions—just substance and strategy.

You can expect:

• Provocative panels with C-suite executives
• Off-the-record insights and open Q&A sessions
• Direct, high-impact exchanges among leaders

If you want to be in the room where it happens, there’s no substitute for being there in person.

SPONSORSHIP OPPORTUNITIES

To maintain the event’s strategic focus, attendance from industry suppliers (e.g., technology, consulting, financial services, etc.) is available only through sponsorship.

Each sponsorship level provides a limited number of attendee badges, ensuring the right mix of participants.

Learn About Sponsorship Options

WATCH HIGHLIGHTS FROM DCLF 2025

Relive the #DCLF2025 energy and hear testimonials directly from participants.

(Can’t see the video above? Click here.)

GET STARTED

Be part of the conversation! Join us at DCLF 2026

Invitations will begin going out in mid-October 2025. You must request an invitation to be considered for attendance. Don’t wait—our curated guest list fills up fast.

Have questions? Interested in sponsorship? Please contact us.

We can’t wait to welcome you to Miami in 2026!

If Banks Sync Data in Real Time, Why Can't Patient Services?

Today’s guest post comes from George Moore, Chief Information Technology Officer at CareMetx.

While banks and logistics companies update data instantly, patient services often rely on delayed, batch-based systems. George examines the challenges of this model and the potential for real-time synchronization to improve coordination and accelerate access to therapy.

To learn more, download the CareMetx case study.

Read on for George's insights.

Hubs: The Bridge Between Patients and Providers

Today’s guest post comes from Josh Marsh, Vice President and General Manager, Sonexus™ Access and Patient Support at Cardinal Health.

Josh examines the central role that hubs play in connecting patients, providers, and other stakeholders. He shares how hubs, by gathering and interpreting real-world insights, can help improve access, adherence, and the overall patient experience.

To learn more about Sonexus Access and Patient Support, download Hubs at the Center of It All.

Read on for Josh’s insights.

Why the Pharmacy Supply Chain Is Broken and How SmithRx Is Fixing It

Today’s guest post comes from Jim Sheninger, Senior Vice President, Supply Chain at SmithRx.

Jim reviews the evolution of pharmacy benefit managers (PBMs) within the drug channel and discusses the challenges that the industry's current dynamics create for plan sponsors, patients, and pharmacies. He then outlines SmithRx’s approach to addressing these issues.

To learn more, visit SmithRx.com.

Read on for Jim’s insights.

Drug Channels News Roundup, August 2025: White Bagging Battles, Private Label Price Hypocrisy, 340B Patient Problems, and UnitedHealth Group’s Woes

Our news-laden summer is ending. Time to pack away your bathing suit, send the kids back to school, and cherish these curated curiosities that I combed from the Drug Channels coastline:

• Aetna’s latest white bagging plan: Saving money or shifting costs?

• 340B covered entities are still not sharing discounts with needy patients

• PBM-affiliated private label biosimilars and their pricing double standard

• UnitedHealth Group’s 2,694 subsidiaries: too big to manage?

P.S. Join my nearly 65,000 LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the DCI community.

Solving the Gross-to-Net Bubble With Better Data

Today’s guest post comes from Angie Franks, CEO at Kalderos.

Angie examines how data fragmentation contributes to inefficiencies in drug discount programs and the broader gross-to-net bubble—the widening difference between a drug’s revenue at list prices and what manufacturers actually receive. Angie outlines how better access to consistent, claims-level data could help reduce waste, improve program integrity, and enhance collaboration among stakeholders in the drug channel.

To learn more, download Following the Dollars: Why 340B Reform Is a Data-Driven Necessity.

Read on for Angie’s insights.

Pharmacy Shakeout: Why U.S. Drugstores Are Disappearing

During my recent video webinar—What’s Next for Retail Pharmacy: Data, Debate, and Disruption—Antonio Ciaccia of 46brooklyn Research joined me to explore the data, trends, and strategic shifts driving a major shakeout in the retail pharmacy sector.

In the short video excerpt below, I break down five key economic forces putting intense pressure on U.S. drugstores. This clip offers just a glimpse of our broader conversation, which also covered PBMs, wholesalers, the evolving competitive landscape, and more.

Can’t see the video? Click here to watch the pharmacy shakeout clip.

Patient Support’s Perfect Storm in 2025: Hits, Misses, and Surprises

Today’s guest post comes from Chris Dowd, Senior VP of Market Development at ConnectiveRx.

Chris revisits his November 2024 forecasts to assess how they’ve held up through mid-2025, giving them an overall grade of A-. He examines which trends played out as expected, where the landscape shifted more dramatically, and how these developments are reshaping patient access strategies.

To learn more, register for ConnectiveRx’s free webinar on September 24: Building Resilient Patient Support When Industry Change Never Stops.

Read on for Chris’s insights.