Last week, we examined the growing concentration of specialty drug dispensing revenues among the largest pharmacies. See The Top 15 Specialty Pharmacies of 2024: How PBMs, Health Systems, and Independents Are Shaping the Market.
Today, we dive deeper. Drawing from DCI’s new 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, we explore how pharmaceutical manufacturers structure their specialty pharmacy networks—and how smaller, independent pharmacies have emerged as dominant players in exclusive networks.
In DCI’s latest analysis, we find specialty pharmacies affiliated with the largest PBMs still play an outsized role in limited networks. But like a certain striped-hatted cat, smaller pharmacies unaffiliated with PBMs show up where few expect them. They dominate exclusive networks and maybe even cleaning up any messes left by Things 1, 2, and 3.
Read on for DCI’s updated profile of specialty networks—and consider why smaller players are showing the good tricks that they know.
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