This week, we’re rerunning some popular posts while we prepare for tomorrow’s live video webinar: 340B in 2026: Market Shifts, Policy Battles, and What They Mean for Stakeholders.

Click here to see the original post from April 2026.
By Adam J. Fein, Ph.D.

Drug Channels Institute’s (DCI’s) latest analysis reveals that PBM-affiliated specialty pharmacies continue to dominate the dispensing of specialty drugs.

For 2025, DCI has identified more than 1,900 dispensing locations with specialty pharmacy accreditation from one or both of the two major independent accreditation organizations. The overall number of accredited locations grew by only 3% in 2025, but is more than five times larger than the 2015 figure.

However, market share for the dispensing of specialty drugs remains highly concentrated. For 2025, the three largest specialty pharmacies accounted for two-thirds of total prescription revenues from pharmacy-dispensed specialty drugs. These businesses are all owned by vertically integrated organizations that also own a PBM.

Below, we share DCI’s latest analysis of the top 15 specialty pharmacies, including updated market shares and revenue estimates, highlighting how vertical integration and channel control continue to reshape specialty dispensing. Despite growth in accredited locations, economic power remains concentrated among a small group of PBM-affiliated entities.
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