A Pharma Wholesaler Scorecard

Every stakeholder’s role in the pharmaceutical supply chain is just as important as the next, and that certainly holds true for that of the drug wholesaler. Essentially, these businesses serve as an intermediary between manufacturers and the downstream chain—after buying medications in bulk from manufacturers, they then distribute these goods to pharmacies, hospitals, and the like.

In the August issue of Pharma Commerce, Editor Emeritus Nick Basta dives deep into the pharma wholesaling sector and notes that, overall, despite the uproar over tariffs, drug costs, and FDA policy, these companies are performing generally well. For one, the Big Three of McKesson, Cencora, and Cardinal Health have maintained steady outputs, with revenues and operating incomes rising at near-double-digit rates last year and so far in 2025. The Healthcare Distribution Alliance, the trade association for US wholesalers, calculates that more than 95% of all prescription shipments are handled by wholesaler-distributors.

Basta also adds that despite antitrust leaders’ criticism of the multitude of acquisitions made by wholesalers as involving potentially exclusionary practices, community practitioners can be a practical alternative to increasingly consolidated health systems that have their own antitrust concerns. In addition, the Big Three can be a helpful backstop for the independent practitioners, experts contend.

It’s important to keep in mind that the stated end goal from all supply chain stakeholders is usually patient access to vital drugs. In pivoting from our August lead feature, a key such component is the 340B Drug Pricing Program, which allows certain providers to purchase meds at discounted prices in order to assist vulnerable populations. However, the federal program does not come without its challenges, notes Kalderos CEO Angie Franks. She writes that, “the increasing complexity of the drug discount ecosystem, paired with a lack of transparent data and insufficient oversight of the growing 340B program itself, has led to unintended discount duplication and unsustainable program costs. When these programs don’t function as intended, patients ultimately pay the price.”

Patients are continuing to have issues even with healthcare plans covering certain drugs to begin with, especially for chronic conditions. In her healthcare reform column this month, Amy Niles of the PAN Foundation reports that since the start of 2025, more than a third (35%) of adults with a chronic condition have faced barriers accessing their medication(s)/treatment(s) through their healthcare plan. She unveils more telling numbers in her piece. As always, thanks for reading.

— Mike Hennessy Jr is chairman and CEO of MJH Life Sciences