NOW AVAILABLE: The 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce Drug Channels Institute’s new 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, now available for purchase and immediate download.

• Download a free 32-page report overview–including Key Industry Trends, What’s New in this edition, the Table of Contents, and a List of Exhibits.

• Review pricing and license options and download the full 2026 report.

Special launch pricing discounts will be valid through April 6, 2026.

This report—our seventeenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. If you make strategic decisions in this industry, this report is essential reading.

WHAT’S INSIDE

• Nearly 1,300 endnotes, most of which have hyperlinks to source materials

• Substantial new material—outlined on page x of the report overview

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.

Want to bundle the report with DCI’s video webinars? Email Marie Caldwell (mcaldwell@hmpglobal.com).

If you preordered, you should have received an email with download instructions last week. Didn’t get it? Contact us at dcisupport@hmpglobal.com, and we’ll take care of it.

WHAT’S GOING ON

Every year, the DCI team researches and writes economic reports with up-to-date, fact-based economic analyses of key drug channel participants. Our reports synthesize a wealth of statistical data, research studies, financial information, and our unique business experiences into definitive, nonpartisan resources.

Our goal is simple: help you understand how the drug channel really works—and where it’s going.

That's why DCI reports are widely used by nearly every company involved in the drug channel:

• Pharmaceutical manufacturers

• Wholesalers, pharmacists, and pharmacy owners

• Payers, insurers, and plan sponsors

• Hospitals, benefit managers, and managed care executives

• Policy analysts, investors, consultants, and more

In other words, this report helps you understand what your customers, partners, and competitors are reading—and how they’re thinking.

The chart below illustrates the depth and breadth of the 2026 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

FUN FACTS ABOUT THE 2026 EDITION

• The 12 chapters are self-contained—you don't need to read them in order. (Really!) Use the report as a reference guide or read it end-to-end. It’s designed as both a foundational resource and a deep dive into the latest trends and developments.

• There are tons of internal hyperlinks to help you navigate and focus on what matters most to you.

• We’ve updated all market and industry data with the most current insights, including our annual analyses of the largest pharmacies, specialty pharmacies, and PBMs.

• Many sections have been expanded and reorganized to better reflect the latest industry developments. Check out the What’s New section in the report overview for details.

• One of the available licenses gives you the option to download an additional PowerPoint file with images of all 270 exhibits—making it easier to share insights with your team. (Note: All license versions include exhibits within the text.)

• There are a staggering 1,284 endnotes (!), most of which have direct hyperlinks to original source materials. This allows you to validate, explore, and go deeper.

• We have reluctantly removed all corny jokes and pop culture references. So, no memes and absolutely no references to SpongeBob SquarePants.

Thank you for your interest in our work. If you have any questions before purchasing a license to the report, please email me. We look forward to helping you succeed in the evolving U.S. drug channel.

Medical Benefit Maximizers Are Emerging as a Critical Market Force: What Manufacturers Need to Understand

Today’s guest post comes from Michael Harris, Vice President of Patient Support Services Strategy at Valeris.

Michael explores the rise of medical benefit maximizers as a new—and often overlooked—force shaping patient access. He outlines how these strategies can erode access, absorb support dollars, and introduce hidden risks for brands.

To learn more about Valeris’ technology solutions and data analytics capabilities, connect with Valeris.

Read on for Michael’s insights

The Top 15 U.S. Pharmacies of 2025: Market Shares and Revenues at the Biggest Chains, PBMs, and Specialty Pharmacies

Next week, the Drug Channels Institute (DCI) will release our 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This 17th edition provides our most comprehensive and up-to-date examination of the U.S. drug pricing, reimbursement, and dispensing system.

For 2025, DCI estimates that total prescription dispensing revenues at retail, mail, long-term care, and specialty pharmacies reached $751 billion in 2025, up 10% from the 2024 figure.

GLP-1 agonist drugs have become the dominant driver of revenue growth. Over the past five years, increases in dispensing revenues from GLP-1 products accounted for about 60% of retail pharmacies’ total revenue growth.

The table below—one of 270 in our new report—racks up DCI's first look at the 15 largest organizations that competed for a share of those dollars. For a sneak peek at the complete report, click here to download our free 32-page report overview (including key industry trends, What's New in this edition, the Table of Contents, and a List of Exhibits). We’re offering special discounted pricing if you order before April 6, 2026.

PBM Industry Update 2026: Trends, Challenges, and What's Ahead.

Don’t miss DCI’s next webinar on April 10, 2026, from 12:00 p.m. to 1:30 p.m. ET. Dr. Adam J. Fein and Bryce Platt will unpack the good, the bad, and the ugly of the PBM industry—and explore what it means for you. Click here to learn more and sign up.

Reshaping Patient Affordability: The Power of Expertise and Agility

Today’s guest post comes from Logan Melchione, Vice President of Patient Affordability at Paysign.

Logan examines how pharmaceutical manufacturers must rethink copay assistance in an era affected by maximizers, accumulators, and intensifying payer scrutiny. She argues that brands can both gain a strategic advantage and safeguard adherence by embracing claims-based precision, real-time adaptability, and transparent program design.

Request an analysis of your copay assistance program by emailing Paysign at affordability@paysign.com or by visiting paysign.com/rx.

Read on for Logan’s insights.

PBM Industry Update 2026: Trends, Challenges, and What’s Ahead (NEW Live Video Webinar)

Join Dr. Adam J. Fein, president of Drug Channels Institute (DCI) and the editor of Drug Channels, for his latest exclusive video webinar:

PBM Industry Update 2026:

Trends, Challenges, and What’s Ahead

This event will be broadcast live on:

Friday, April 10, 2026

12:00 p.m. to 1:30 p.m. ET

Dr. Fein will be joined by Bryce Platt, a Director at DCI and an expert on PBMs' contractual and business relationships with plan sponsors.

The webinar will be broadcast live from the Drug Channels studio in beautiful downtown Philadelphia. It is part of The Drug Channels 2026 Video Webinar Series.

Register Now

Jump to:

• What You Will Learn
• Pricing Options
• Important Things To Know

WHAT YOU WILL LEARN

Join industry expert Adam J. Fein, Ph.D., and his colleague Bryce Platt for an exclusive deep dive into the latest trends, data, and strategies shaping the pharmacy benefit management (PBM) industry. Drawing from the brand-new 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, they will provide invaluable insights to help you and your team stay informed about this rapidly evolving market.

Adam and Bryce will share their expert analysis on critical industry developments, including:

• The competitive landscape of major PBMs, with exclusive new market share data from DCI

• Key business trends among leading PBMs and their impact on the market

• PBMs’ expanding role in specialty pharmacy and how it’s reshaping the industry

• Exclusive insights into the Federal Trade Commission’s settlement with Express Scripts

• The outlook for the rebate system and the emergence of the Net Pricing Drug Channel

• What the Consolidated Appropriations Act of 2026 (CAA) means for PBMs’ profits and business strategies

• The evolving role of independent PBMs and their market positioning

• How health-system-owned PBMs are changing the game

• Fresh data on plan sponsors’ perspectives on their PBM partners

• Key takeaways from PBMs’ 2026 commercial formularies

• The coming shifts in PBM compensation models

• The risks and rewards of PBM-affiliated private-label products and GPOs

• Latest developments in the 340B Drug Pricing Program

• State and federal PBM regulations: What’s ahead?

• Emerging controversies, challenges, and threats to watch in the industry

And much more!

As always, the presenters will clearly distinguish their opinions and interpretations from the objective facts and data.

This 90-minute video webinar will feature a dedicated Q&A session, where attendees can unmute and engage directly with Adam and Bryce.

Register now to stay informed and get ahead of the curve on the PBM 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. What's more, an unlimited number of attendees can watch together at a single physical location with one registered device.

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 register. 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.)

PBM Industry Update 2026: Trends, Challenges, and What’s Ahead

Questions about corporate pricing? Please contact Marie Caldwell (mcaldwell@hmpglobal.com).

Purchasing access for multiple sites? We'll contact you for your participant list. Or, download this spreadsheet and email your registrants’ information to dcisupport@hmpglobal.com.

Payment can be made with all major credit cards (Visa, MasterCard, American Express, and Discover). Prefer check or ACH? Click here to request an invoice.

Click here for other important things to know about this event.

Time to Evolve: Hubs Flex to New Demands

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

Josh examines how hub models are evolving under mounting commercial, operational, and technological pressures. He argues that the next generation of patient services will be defined not by a single model, but by adaptability and shared strategy.

To learn more, download Cardinal Health’s latest hub evolution insights from its two-year trend archive: 2026 insourcing and outsourcing trends for patient hubs.

Read on for Josh’s insights.

Preorder Now: DCI’s 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 24, 2026, Drug Channels Institute will release The 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our seventeenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. If you make strategic decisions in this industry, this report belongs on your desk.

12 chapters, 500+ pages, 270 exhibits, and nearly 1,300 endnotes. No other resource matches the scope, depth, and rigor of this resource.

We are offering you the opportunity to preorder the thoroughly updated, revised, and expanded 2026 edition at special discounted prices. Preordering guarantees early access and locks in the lowest available price. Those who preorder will receive a download link before March 30.

• Download a free 32-page pre-publication overview (including Key Industry Trends, What's New in this edition, the Table of Contents, and a 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.

Email Marie Caldwell (mcaldwell@hmpglobal.com) if you’d like to bundle the report purchase with access to DCI’s video webinars.

Special preorder and launch pricing discounts will be valid through April 6, 2026. After that date, prices increase. Secure your discount now.

The report was researched and written by the Drug Channels Institute team, led by Adam J. Fein, Ph.D. As shown below, the 2026 edition delivers unmatched depth and breadth. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

The 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers contains the most current market and industry data available, including DCI’s annual analyses of the market positions of the largest pharmacies, specialty pharmacies, and PBMs. Throughout the report, we have added new industry data, deepened our coverage of many topics, and expanded our analysis of emerging trends.

This definitive, nonpartisan report will aid pharmaceutical manufacturers, wholesalers, pharmacists, pharmacy owners, hospital executives, pharmacy buyers, benefit managers, managed care executives, policy analysts, investors, consultants, and anyone else who wants to understand and benefit from this ever-changing industry. If your organization competes, negotiates, invests, or sets policy in this market, this report will sharpen your strategy.

There are many notable updates in this 2026 edition, including:

• A new Section 4.3.4. analyzes manufacturers’ direct-to-patient (DTP) websites and TrumpRx within the broader context of patient-paid prescriptions.

• A new Section 5.5. deconstructs the three largest PBMs’ gross profits. Some of this material previously appeared in Chapter 11.

• Material in Section 7.1., Section 9.1., and Section 9.3. reflects the PBM legislative reforms contained within the Consolidated Appropriations Act, 2026 (P.L. 119-75), which became law in February 2026.

• Material in Section 8.4. and Section 9.3. incorporates implications of the 2026 settlement between Express Scripts and the Federal Trade Commission.

• A new Section 6.3.3. reviews research on how the IRA’s implementation has affected out-of-pocket spending by Medicare Part D beneficiaries.

• A new Section 11.2.4. analyzes pharmacies’ dispensing profits under the Inflation Reduction Act of 2022 (IRA).

• A new Section 12.1.4. evaluates the potential implications of most favored nation (MFN) and tariff policies on the drug channel.

• In Section 12.3.1., our illustration of major vertical business relationships among drug channel businesses now incorporates affiliated third-party administrators (TPAs) and administrative services only (ASO) platforms.

• We have also improved our presentation of material about the IRA and the 340B Drug Pricing Program.

You can read about these changes starting on page x of the report overview.

Thank you for your interest in our work. If you have any questions before purchasing a license to the report, please email me. We look forward to supporting your team’s success in 2026.

Beyond DTP 2.0: How Flexible Direct-to-Patient Programs Power Best-In-Class Patient Experiences

Today’s guest post comes from Allison Bridges, SVP Client Success at PHIL Inc. and Cindy Eckert, Founder and CEO of Sprout Pharmaceuticals

Allison and Cindy argue that many direct-to-patient (DTP) programs remain constrained by one-size-fits-all models that limit both patient experience and commercial performance. As patients increasingly expect convenience, choice, and price transparency, they suggest that manufacturers must evolve beyond static DTP channels toward more flexible, hybrid access models.

Click here to learn more about PHIL’s DTP 2.0 platform, PHIL Direct.

Read on for Allison and Cindy’s insights.

Drug Channels News Roundup, February 2026: Mark Cuban on FTC-ESI, What Patients Really Want, QALYs vs. MFN, 340B’s Site of Care Shift, and New Faces at DCI

Despite the recent storm, winter—or at least February—is almost over. Before we thaw out, here’s a brisk tour of the forces reshaping the drug channel. In this issue:

• Mark Cuban’s $0.02 on the FTC-ESI settlement

• What patients want from health insurance

• Why the QALY paradox could block MFN

• How 340B drives hospital vertical integration

Plus: Meet the expanding Drug Channels Institute team!

P.S. Join my more than 68,000 LinkedIn followers for links to neat stuff, along with unfiltered commentary from the DCI community.

The State of Patient Access: What Industry Leaders Reveal in a New Survey About Hub Models, Technology, and the Road Ahead

Today’s guest post comes from Scott Genone, Chief Product Officer at CareMetx.

Scott shares findings from CareMetx’s 2026 Patient Services Report, based on a survey of more than 100 patient access decision-makers across biopharma, consulting, and specialty care. The results reveal an industry in transition. Hybrid hub models are becoming the norm, technology enablement remains uneven, and interoperability is emerging as a critical gating factor for meaningful progress.

To learn more, download CareMetx's 2026 Patient Services Report.

Read on for Scott’s insights.

Medicare Part D Pharmacy Networks in 2026: Supermarkets Dominate as Drugstores Stall and Independents Walk Away

The Centers for Medicare & Medicaid Services (CMS) has just released its initial 2026 data on enrollment in Medicare Part D prescription drug plans (PDPs).

DCI’s exclusive analysis shows that 83% of seniors remain enrolled in PDPs with preferred pharmacy networks—essentially unchanged from 82% in 2025, but sharply lower than the 99% peak in 2023. Meanwhile, the number of major Part D plans offering preferred networks has fallen to a record-low eight.

The new enrollment data reveal a clear shift in competitive positioning: Albertsons and Publix are now preferred in every major plan. Walgreens is holding strong. Walmart—the company that invented the Part D preferred network model—has slipped to the middle of the preferred pack.

Meanwhile, smaller pharmacies have fully abandoned PDPs’ preferred networks in 2026.

At the same time, the IRA’s expansion of the Low-Income Subsidy (LIS) means a growing share of beneficiaries have little financial incentive to use a preferred pharmacy at all. Add in the PBM reforms in the Consolidated Appropriations Act of 2026, and the preferred network model will gradually lose relevance.

The Key to a Better Patient Experience: Improved GTN

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

Gerard reframes patient affordability as a clinical issue rather than a purely financial one. He argues that real-time precision, earlier intervention, and coordinated escalation can reduce gross-to-net failures and improve the patient experience.

To learn more about RIS Rx’s approach, request a RIS Rx savings snapshot.

Read on for Gerard’s insights.