Happy 249th birthday, America! Before you launch your July 4 festivities, Drug Channels humbly offers some fact-based fireworks to heal our troubled nation:
Plus, Mark Cuban's blunt take on why CEOs fuel the PBM status quo.
P.S. Join my nearly 64,000 LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the Drug Channels community.

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...
Tuesday, June 24, 2025
Friday, June 20, 2025
Transparency vs. Reality: Troubling Lessons from PBM Disclosure Laws (rerun)
This week, I’m rerunning some popular posts while I prepare for today’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.
Click here to see the original post from March 2025.
Last week, President Trump signed yet another executive order, this time promising to make healthcare pricing more transparent.
While this marks another federal push for disclosure, states have already been quite active in this space. Since 2017, 24 states have passed 38 laws targeting healthcare transparency, with a strong focus on unraveling the complex economics of pharmacy benefit managers (PBMs).
But has all this legislation actually provided clarity—or just more red tape?
Below, I analyze four state reports on manufacturers’ rebate and fee payments to PBMs. The findings are dispiriting: mandated disclosures have yielded little actionable, reliable data. Lawmakers got to pat themselves on the back for “transparency,” but the data tell a different story. Federal efforts haven’t been much better.
Should we continue down the path of government-mandated reporting, or should plan sponsors be left to negotiate their own deals?
Click here to see the original post from March 2025.
Last week, President Trump signed yet another executive order, this time promising to make healthcare pricing more transparent.
While this marks another federal push for disclosure, states have already been quite active in this space. Since 2017, 24 states have passed 38 laws targeting healthcare transparency, with a strong focus on unraveling the complex economics of pharmacy benefit managers (PBMs).
But has all this legislation actually provided clarity—or just more red tape?
Below, I analyze four state reports on manufacturers’ rebate and fee payments to PBMs. The findings are dispiriting: mandated disclosures have yielded little actionable, reliable data. Lawmakers got to pat themselves on the back for “transparency,” but the data tell a different story. Federal efforts haven’t been much better.
Should we continue down the path of government-mandated reporting, or should plan sponsors be left to negotiate their own deals?
Labels:
Gross-to-Net Bubble,
Health Care Policy,
PBMs
Thursday, June 19, 2025
Mapping the Vertical Integration of Insurers, PBMs, Specialty Pharmacies, and Providers: DCI’s 2025 Update and Competitive Outlook (rerun)
This week, I’m rerunning some popular posts while I prepare for tomorrow'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.
Click here to see the original post from April 2025.
It's time for Drug Channels’ annual update of vertical integration among insurers, PBMs, specialty pharmacies, and healthcare services within U.S. drug channels. As you can see below, we have revised, renovated, and refurbished our infamous illustration of the major vertical business relationships among the largest companies.
Proponents of these vertical integration arrangements argue that they create opportunities to mine healthcare costs. However, these organizations remain highly controversial, due to the potential for anti-competitive behavior. We summarize some of the key issues below.
While some major companies have narrowed their focus or unwound previous integration efforts, ongoing consolidation and selective deconsolidation will continue to reshape the healthcare biome by trying to build something epic, block by block.
Click here to see the original post from April 2025.
It's time for Drug Channels’ annual update of vertical integration among insurers, PBMs, specialty pharmacies, and healthcare services within U.S. drug channels. As you can see below, we have revised, renovated, and refurbished our infamous illustration of the major vertical business relationships among the largest companies.
Proponents of these vertical integration arrangements argue that they create opportunities to mine healthcare costs. However, these organizations remain highly controversial, due to the potential for anti-competitive behavior. We summarize some of the key issues below.
While some major companies have narrowed their focus or unwound previous integration efforts, ongoing consolidation and selective deconsolidation will continue to reshape the healthcare biome by trying to build something epic, block by block.
Wednesday, June 18, 2025
The Top 15 Specialty Pharmacies of 2024: How PBMs, Health Systems, and Independents Are Shaping the Market (rerun)
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.
Click here to see the original post from April 2025.
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.
Click here to see the original post from April 2025.
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.
Tuesday, June 17, 2025
The Top Pharmacy Benefit Managers of 2024: Market Share and Key Industry Developments (rerun)
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.
Click here to see the original post from March 2025.
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.
Click here to see the original post from March 2025.
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.
Monday, June 16, 2025
The Top 15 U.S. Pharmacies of 2024: Market Shares and Revenues at the Biggest Chains, PBMs, and Specialty Pharmacies (rerun)
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.
Click here to see the original post from March 2025.
Next week, Drug Channels Institute (DCI) will release our 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 16th edition of our popular and comprehensive examination of the entire U.S. drug pricing, reimbursement, and dispensing system.
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).
Click here to see the original post from March 2025.
Next week, Drug Channels Institute (DCI) will release our 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 16th edition of our popular and comprehensive examination of the entire U.S. drug pricing, reimbursement, and dispensing system.
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).
Labels:
Channel Management,
Industry Trends,
PBMs,
Pharmacy,
Specialty Drugs
Friday, June 13, 2025
Starting with the End in Mind: How Pharma Can Build a Smarter Path to Commercialization
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.
To learn more, view their latest webinar: Meet the Expert: Developing Your Commercial Strategy in Phases II-III.
Read on for Sean and Carolyn’s insights.
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.
To learn more, view their latest webinar: Meet the Expert: Developing Your Commercial Strategy in Phases II-III.
Read on for Sean and Carolyn’s insights.
Labels:
Guest Post,
Sponsored Post
Tuesday, June 10, 2025
The 340B Contract Pharmacy Market in 2025: Big Chains and PBMs Tighten Their Grip
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:
For more on what the 340B program’s growth means for pharmacies, join Adam J. Fein, Ph.D., and Antonio Ciaccia on June 20 for a new live video webinar: What’s Next for Retail Pharmacy: Data, Debate, and Disruption.
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.
For more on what the 340B program’s growth means for pharmacies, join Adam J. Fein, Ph.D., and Antonio Ciaccia on June 20 for a new live video webinar: What’s Next for Retail Pharmacy: Data, Debate, and Disruption.
Labels:
340B,
Hospitals,
Industry Trends,
PBMs,
Pharmacy,
Specialty Drugs
Friday, June 06, 2025
Moving Beyond Mitigation: Cracking the Maximizer Code to Protect Patient Affordability
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.
Read on for Logan’s insights.
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.
Read on for Logan’s insights.
Labels:
Guest Post,
Sponsored Post
Tuesday, June 03, 2025
Pharmacist Salaries and Employment in 2024: Retail Employment Collapse Offset by Hospital Boom
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.
Downsizing by the larger pharmacy chains, combined with Rite Aid’s liquidation, means that 2025 looks even grimmer for retail pharmacists. Full salary and employment data below for your enjoyment or sorrow. Click here to share your thoughts on the pharmacist job market with the Drug Channels LinkedIn community.
Jump to:
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.
Downsizing by the larger pharmacy chains, combined with Rite Aid’s liquidation, means that 2025 looks even grimmer for retail pharmacists. Full salary and employment data below for your enjoyment or sorrow. Click here to share your thoughts on the pharmacist job market with the Drug Channels LinkedIn community.
Jump to:
UPCOMING LIVE VIDEO WEBINAR!
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.
Labels:
Hospitals,
Industry Trends,
Pharmacy,
Pharmacy Economics
Friday, May 30, 2025
Three Ways GoodRx Is Helping Pharmacies Increase Profitability and Drive Innovation
Today’s guest post comes from Aaron Crittenden, President of Rx Marketplace at GoodRx.
Aaron introduces us to GoodRx Community Link, a new offering from GoodRx that allows independent pharmacies to contract directly with GoodRx.
Aaron introduces us to GoodRx Community Link, a new offering from GoodRx that allows independent pharmacies to contract directly with GoodRx.
To learn about GoodRx Community Link, register for GoodRx’s free webinar on either June 3, 2025, or June 4, 2025. Both webinars will be held at 11:00 a.m. ET.
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.
Read on for Aaron’s insights.
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.
Read on for Aaron’s insights.
Labels:
Guest Post,
Sponsored Post
Wednesday, May 28, 2025
Drug Channels News Roundup, May 2025: MFN Controversy, Plan Sponsors ♥️ Rebates, PBM Profits, and Fun in Congress
Summer unofficially began over the weekend. To mark the occasion, here are a few hot items, freshly seared on the Drug Channels grill:
Plus: A special moment for DCI on Capitol Hill.
P.S. Join my 63,000+ LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the DCI community.
P.S. Join my 63,000+ LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the DCI community.
What’s Next for Retail Pharmacy: Data, Debate, and Disruption.
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!