Which Specialty Pharmacies Were the Big Dogs in 2020?

Specialty Pharamcy

Everyone in the specialty pharmacy business sits up and pays attention whenever a specialty pharmacy is acquired or announces big news. After all, good competition prompts smart companies to work harder to slog their way up the leaderboard.

Each year Drug Channels publishes its list of the Top 15 Specialty Pharmacies. (Can’t tell you how often that list is used in presentations.) We’ve seen the big box pharmacies retain their positions year after year. What has been more interesting is watching the smaller pharmacies elbow themselves onto the list. Many at the top of the list have acquired SPs at the bottom of the list. The smaller players know that and are eager to preen themselves for these suitors. Many ‘targets’ were on the list only for a year or so before getting gobbled up.

But, we have to wonder whether we’ll be seeing aspiring specialty pharmacies make the list in coming years. Just look at the companies that made this year’s list. (Click the link below for access to the article.)

The big box SPs are still there, albeit some of the names have changed, with a lion-sized market share. It is noteworthy that supermarket-owned specialty pharmacies now command the middle third of the list and half of the bottom third! But what is missing? There is not a single independent specialty pharmacy in stark comparison to the same list only a few years ago.

How will the list change in future years? Here’s our prediction.
First, assuming data can be extracted, the hospital and health system owned specialty pharmacies must start to appear. They have the potential to rise rapidly into the Top 15 club…. and might have even qualified this year. Without including these entities there will be a big hole in the analysis. Second, there has been a big uptick in the number of orphan therapies that are uber expensive. The specialty pharmacies that are winning limited (often exclusive) distribution deals for rare therapies can quickly rack up enough $$$$$s to also earn a spot on the list. Any buy-and-bill revenue from these direct-to-office therapies should also be credited to these organizations to reflect an accurate picture of the broader specialty pharmacy market.



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