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Did You Know? |
- The U.S. pharmacy landscape is diverse, encompassing several primary categories that serve distinct patient needs. Chain pharmacies, with about 38,000 locations dominated by CVS and Walgreens, provide broad
retail coverage and convenience. Independent community pharmacies, numbering 18,984 locations, are deeply embedded in local communities, often serving rural and small‑town populations with personalized care.
Specialty pharmacies focus on complex, high‑cost medications such as biologics and GLP‑1 therapies, catering to patients with chronic or rare conditions. Mail‑order pharmacies emphasize
efficiency and cost savings, delivering maintenance medications directly to patients’ homes. Hospital‑based pharmacies integrate tightly with inpatient and outpatient care, ensuring continuity of
treatment within healthcare systems. Finally, clinical pharmacies specialize in medication therapy management, disease state monitoring, and direct collaboration with physicians to optimize patient outcomes.
Together, these categories form a multifaceted ecosystem, balancing accessibility, specialization, and patient‑centered services across the country.
- California tops the nation with 8,015 total pharmacies, followed by Texas with 6,847, Florida at 5,923, New York with 5,156, and Pennsylvania at 4,789. While these figures highlight the sheer scale of
pharmacy presence in the most populous states, the per‑capita distribution tells a different story. Rural states often have far fewer pharmacies per 10,000 residents, leaving communities with limited access
to medications and healthcare services. By contrast, urban areas with higher population density tend to support a greater number of pharmacies, ensuring more convenient access. This uneven distribution underscores
a critical challenge: although the overall number of pharmacies is substantial, geographic disparities mean that rural populations remain at risk of reduced healthcare availability, reinforcing the importance of
independent pharmacies that often serve as the only healthcare destination in smaller towns.
- Contemporary pharmacies have evolved into multifunctional healthcare centers, offering a wide spectrum of clinical and patient‑focused services that extend far beyond dispensing prescriptions. Among independent
pharmacies, 91% provide immunizations, 64% monitor blood pressure, 58% deliver diabetes management programs, and 81% conduct medication therapy management to optimize patient outcomes. Many also embrace specialized
offerings such as pharmacogenomics testing, medication synchronization, compounding services, and even CBD consultation, reflecting their adaptability to diverse patient needs. In addition, pharmacies frequently
support communities with medical equipment rentals and comprehensive health screenings, reinforcing their role as accessible care providers. Advanced facilities are pushing the boundaries further by integrating
telepharmacy services—which enable 24/7 counseling and emergency prescription access—and adopting digital health platforms that connect patients remotely, ensuring continuity of care and expanding reach into
underserved populations. This transformation positions pharmacies as frontline healthcare destinations, blending convenience, technology, and personalized service into a single point of care.
- Remote patient monitoring and virtual consultations are transforming pharmacies into always‑accessible healthcare hubs, extending their reach into underserved and rural communities where traditional medical
infrastructure is limited. By leveraging connected devices and digital platforms, pharmacies can track patients’ vital signs, medication adherence, and chronic disease management in real time, ensuring proactive
interventions without requiring in‑person visits. Complementing this, telepharmacy services deliver 24/7 medication counseling and emergency prescription access, bridging critical gaps for populations in remote
areas. Together, these innovations not only enhance convenience and continuity of care but also reinforce pharmacies’ role as frontline providers, ensuring that even the most geographically isolated patients
have reliable access to professional guidance and essential treatments.
- Pharmacies have steadily evolved into comprehensive healthcare hubs, expanding well beyond the traditional role of dispensing medications. Among independent pharmacies, 91% now provide immunizations, making them
frontline providers in preventive care. In addition, 67% offer health screenings, 58% deliver chronic disease management programs, and 81% conduct medication therapy management, ensuring patients receive guidance on
safe and effective drug use. This breadth of services often surpasses what urgent care centers deliver in many communities, positioning independent pharmacies as accessible, trusted providers of clinical care. Their
ability to combine convenience with personalized service has made them indispensable in smaller towns and underserved areas, where they frequently serve as the most immediate and reliable healthcare destination.
- Independent pharmacies consistently demonstrate superior performance compared to chain competitors, particularly in measures that matter most to patients. Satisfaction rates reach 96% for independents versus
just 78% for chains, reflecting the value of personalized service and community trust. Consultation times average 12 minutes in independents compared to only 3 minutes in chains, allowing pharmacists to engage
meaningfully with patients about medications, health conditions, and preventive care. Accuracy is another area of strength, with independents achieving 99.8% prescription accuracy versus 96.2% for chains,
underscoring their meticulous attention to detail. Beyond dispensing, independents deliver more comprehensive clinical services, including immunizations, health screenings, chronic disease management, and
medication therapy management programs. Taken together, these figures highlight a striking reality: when it comes to spending time with patients and delivering holistic care, independent pharmacies lead by
a wide margin, reinforcing their role as trusted healthcare destinations across the country.
- The U.S. independent pharmacies market was valued at $172.56 billion in 2024 and is projected to grow steadily at a compound annual growth rate (CAGR) of 4.26% from 2025 through 2033. This trajectory reflects
both the resilience and adaptability of independents, which continue to diversify services despite reimbursement pressures and rising costs. The study underpinning these figures examined more than 11,000 independent
pharmacies at the state level, providing granular insights into their locations, ownership structures, addresses, and operational parameters. Such detail highlights the critical role independents play in healthcare
delivery, especially in smaller communities, while also offering a roadmap for policymakers and industry stakeholders to understand how these pharmacies are distributed and how they contribute to patient access
across the country.
- In 2025, independent pharmacies remain a vital pillar of healthcare access in the United States, with around 19,000 locations operating nationwide and nearly two‑thirds serving communities of fewer
than 50,000 residents. Their presence ensures that smaller towns and rural areas—often underserved by larger chains—retain essential access to medications, vaccines, and personalized patient care. Beyond
dispensing prescriptions, these pharmacies frequently provide expanded services such as immunizations, long‑term care support, and collaborations with other healthcare professionals, reinforcing their
role as trusted community anchors even as financial pressures and industry consolidation continue to challenge their survival.
- Independent pharmacies have increasingly positioned themselves as community healthcare destinations, expanding far beyond the traditional role of dispensing medications. By 2024, an impressive 93% offered
influenza vaccines, underscoring their role in preventive care and public health. Nearly 46% had formal contracts with non‑pharmacy healthcare professionals, such as nurse practitioners or physicians, to broaden
the scope of services available on site. In addition, 55% provided long‑term care services, supporting patients in nursing facilities, residential care, or aging at home. This diversification reflects both necessity
and opportunity: independents are adapting to shrinking prescription margins by embedding themselves deeper into the healthcare ecosystem, offering accessible, localized services that strengthen their relevance and
resilience in a fiercely competitive market.
- Independent pharmacies have seen their gross margins stabilize around 21% in 2024 and 2025, down slightly from the 21.9% reported in 2020 and the consistent 21.8–22.0% range observed between 2016 and 2019.
In 2022, margins dipped to 21%, marking the lowest point in a decade, and the trend has persisted as reimbursement pressures from Pharmacy Benefit Managers and rising payroll, compliance, and technology costs
continue to erode profitability. Even as industry revenues expand—driven by high‑demand therapies such as GLP‑1 drugs—independent pharmacies often face negative reimbursements on these prescriptions, leaving
them vulnerable in a market dominated by chains, PBMs, and mail‑order competitors. The result is a paradox: an industry generating hundreds of billions in revenue, yet independents struggle to survive, with
closures occurring at a rate of more than one per day.
- Independent pharmacies continued to struggle in 2024 and 2025, with gross profit margins holding near 21%, slightly below the 21.9% reported in 2020 and well under the 19.7% low point seen in 2023. The sector’s
financial strain was driven by below‑cost third‑party reimbursements, rising payroll and overhead expenses, and the growing dominance of chains, PBMs, and mail‑order pharmacies. By mid‑2024, the number of independent
community pharmacies had fallen to 18,984 locations, down from 19,432 the year before, a contraction equal to more than one closure per day. Revenues remained significant—independents represented nearly $95 billion
in 2023—but profitability was increasingly elusive, leaving many operators caught between massive industry growth and razor‑thin margins that threatened long‑term survival.
- By June 2024, the number of independent community pharmacies in the United States had dropped to 18,984 locations, down from 19,432 the year before, a contraction that translates into the closure of more than one
pharmacy per day. This decline highlights the mounting financial pressures independents face, including shrinking reimbursement rates, rising operating costs, and intensifying competition from chains, PBMs, and
mail‑order services. While these pharmacies remain vital in rural and underserved areas, the steady erosion of their numbers underscores the fragility of the independent sector within an industry that otherwise
generates hundreds of billions in annual revenue.
- Pharmacy revenues flow from a mix of prescription drugs, over‑the‑counter products, vitamins, cosmetics, groceries, and other merchandise, though in a typical independent pharmacy more than 90% of sales come
from prescriptions. Profitability hinges on the relationship between revenues and costs: gross profit is calculated as revenues minus the cost of products purchased from manufacturers or wholesalers (net of
discounts and returns), while the gross margin expresses that profit as a percentage of revenues. Gross profit represents the pool of funds available to cover operating expenses, which include payroll—wages,
taxes, and benefits for staff and owners—and general business costs such as rent, utilities, license fees, insurance, and advertising. Operating income is what remains after subtracting these expenses from
gross profit, meaning a pharmacy is only profitable if gross profits exceed operating costs. Interestingly, a pharmacist‑owned drugstore could show a “net loss” if the owner elects to take a larger salary,
even though the business is generating sufficient gross profit. To capture this nuance, analysts use Owner’s Discretionary Profit (ODP), defined as the sum of the owner’s compensation and the pharmacy’s
operating income. While the NCPA Digest once reported ODP as a key measure of financial health, it has stopped publishing the figure in recent years, leaving a gap in transparency around how independent
pharmacies balance compensation with profitability.
- Competition in the U.S. pharmacy landscape is intense, with more than 41,000 pharmacies operating nationwide. The market is dominated by large chains such as CVS, Walgreens, and Walmart, which leverage scale,
purchasing power, and expansive networks to capture the majority of prescription sales. Alongside these giants, independent pharmacies remain vital, particularly in rural and underserved communities where they often
serve as the only accessible healthcare providers. Supermarket pharmacies add another layer of competition, offering convenience by bundling prescriptions with grocery shopping. This crowded environment creates constant
pressure on margins, forcing independents to differentiate through personalized service and community ties, while chains compete on efficiency, brand recognition, and integrated healthcare offerings. The result is a
fragmented yet highly competitive industry where survival often depends on balancing scale, service, and adaptability.
- Prescription drugs dominate pharmacy revenue streams, representing the majority of overall sales, yet they often deliver the lowest profit margins due to strict pricing controls and reimbursement pressures. To
balance this, pharmacies lean heavily on front-of-store items—such as over-the-counter medications, cosmetics, personal care products, and even snacks—which provide significantly higher margins. This dual structure
creates a fascinating dynamic: the prescription side ensures steady traffic and massive revenue volume, while the retail side quietly drives profitability. In effect, the pharmacy counter acts as the anchor, while
the aisles of everyday goods are the hidden engine sustaining financial health.
- Opening a pharmacy is a capital-intensive venture, typically requiring $250,000 to $600,000 in upfront investment. This substantial range reflects the costs of securing inventory, obtaining the necessary licenses
and permits, and hiring qualified pharmacists and support staff. Beyond these essentials, expenses also include leasehold improvements, technology systems for prescription management, insurance, and marketing to
establish a customer base. Independent pharmacies often face higher relative costs compared to chains, since they lack the purchasing power and infrastructure of large corporations. The steep startup requirements
underscore why many new entrants struggle to compete in a market dominated by established players, despite the industry’s enormous revenue potential.
- Pharmacies operate on surprisingly thin margins despite their enormous revenues, with average net profits hovering between 2–5%. This is significantly lower than many other retail sectors, largely because of high
operating costs—including staffing, compliance, and inventory management—and the constant squeeze from reimbursement pressures imposed by Pharmacy Benefit Managers (PBMs). While prescription drugs generate the bulk
of sales, they often yield the lowest margins, forcing pharmacies to rely on higher-profit items like over-the-counter medications, cosmetics, and convenience goods to balance the books. The result is an industry that
looks massive from the outside but often struggles to maintain profitability once the costs and reimbursement dynamics are factored in.
- In 2025, pharmacies and drug stores across the United States generated a staggering $609.6 billion in revenue, supported by roughly 41,255 businesses and employing close to 1 million workers. Despite
the massive scale, profit margins remained slim at just 2–5%, squeezed by rising labor costs, regulatory compliance, and shrinking reimbursement rates from Pharmacy Benefit Managers. Chains such as CVS, Walgreens,
and Walmart dominated the market, while independent pharmacies continued to serve rural and underserved communities under mounting pressure. Growth was fueled by an aging population, the increasing
prevalence of chronic diseases, and expanded Medicare and Medicaid coverage, yet competition from online and mail-order pharmacies intensified. To offset thin margins, many pharmacies leaned on higher-profit
front-of-store sales like over-the-counter medications, cosmetics, and snacks, highlighting the paradox of an industry that commands enormous revenues but fights daily for profitability.
- In 2024, the U.S. pharmacy industry surged to nearly $683 billion in revenue, a sharp 9% jump from 2023’s $621 billion, fueled primarily by the booming demand for GLP‑1 agonist drugs such as Ozempic and Wegovy,
which alone accounted for more than 80% of dispensing revenue growth. Despite this extraordinary expansion, profit margins remained thin at just 2–5%, squeezed by reimbursement pressures from Pharmacy Benefit Managers
and rising operational costs. The market was dominated by giants like CVS Health, Walgreens Boots Alliance, Cigna/Express Scripts, and UnitedHealth/OptumRx, while specialty pharmacies thrived in biologics and chronic
disease treatments, and mail‑order services gained traction for long‑term prescriptions. Independent pharmacies continued to struggle against consolidation, with closures in rural areas highlighting access concerns,
even as the overall industry grew larger and more complex than ever.
- In 2024, the U.S. prescription dispensing market was heavily concentrated, with the four largest companies controlling nearly half of all revenues. CVS Health led the pack with a 25.8% market share, generating
$176.3 billion, followed by Walgreens Boots Alliance at 19.2% ($131.2 billion). Cigna’s Express Scripts held 12.7% ($86.8 billion), while UnitedHealth Group captured 10.1% ($69.0 billion). Together, these giants
accounted for almost $463 billion in dispensing revenues, underscoring the dominance of vertically integrated corporations that combine insurance, pharmacy benefit management, and retail operations. This level of
concentration raises significant concerns about reduced competition, limited patient choice, and the growing vulnerability of independent pharmacies, which struggle to compete against the scale, negotiating power,
and integrated networks of these industry leaders. The result is a marketplace where half of prescription revenues flow through just four companies, reshaping the balance of power in American healthcare.
- In 2023, total prescription dispensing revenues across retail, mail, long‑term care, and specialty pharmacies reached $621 billion (excluding COVID‑19 vaccines), but by 2024 the figure surged to $683 billion, marking
a 9% year‑over‑year increase. Early 2025 estimates suggest revenues will remain near or above this level, with growth fueled primarily by GLP‑1 agonist drugs such as Ozempic, Wegovy, Mounjaro, and Zepbound, which
accounted for more than 80% of revenue growth at retail pharmacies. This boom in high‑demand therapies underscores the sector’s momentum, yet also highlights the dominance of specialty and mail‑order channels, as
well as the consolidation of power among the largest chains and PBMs that together control nearly half of all dispensing revenues. The result is a marketplace generating well over $680 billion annually, reshaped
by blockbuster drugs and concentrated corporate influence.
- By the end of 2023, despite nine manufacturers launching 14 biosimilar versions of Humira, the best‑selling pharmaceutical in the United States, their collective market share remained below 3%. This limited
uptake reflects the complex dynamics of biosimilar adoption, where pharmacy benefit managers (PBMs) and payers wield significant influence through formulary design, rebate negotiations, and tiered coverage
strategies. Many PBMs initially favored the originator Humira due to entrenched rebate structures, while selectively granting access to certain biosimilars to create competitive leverage. As a result, the
biosimilar market faced slow penetration, even though these alternatives were priced lower. Going forward, the strategies of PBMs and payers—ranging from exclusive contracting to step‑therapy requirements—
will determine whether biosimilars can gain meaningful traction and reduce overall drug spending in the autoimmune and inflammatory disease categories where Humira dominates.
- In 2023, the U.S. pharmacy industry generated $569.8 billion in revenue, and projections suggest it will climb to $683.8 billion by 2028, underscoring steady growth despite mounting pressures. The largest revenue
driver was branded prescription drugs at $334.4 billion, followed by generic drugs at $83.8 billion, while nonprescription medicines contributed $29.6 billion. Beyond prescriptions, pharmacies captured additional
streams through groceries and food items ($14.8 billion), personal health supplies ($14.2 billion), cosmetics ($13.1 billion), and vitamins, minerals, and dietary supplements ($8.5 billion). With more than 45,000
pharmacies nationwide, ranging from dominant chains to independents and supermarket outlets, the competitive landscape remains fierce, forcing businesses to balance razor-thin margins with diversification strategies
that extend well beyond the pharmacy counter.
- South America's most renowned pharmacy chains are firmly embedded in their local markets, earning widespread trust and recognition. In Brazil, Drogasil and Droga Raia—both under the umbrella of
RD Saúde (Raia Drogasil)—rank among the largest, boasting thousands of locations nationwide. Pague Menos, another major Brazilian chain, is celebrated for its extensive reach and around-the-clock service
in many cities. In Argentina, Farmacity leads the way in pharmacy and health retail, particularly in urban centers like Buenos Aires. Farmacias Ahumada holds strong brand recognition in Chile, while
Farmatodo, originally from Venezuela, has successfully expanded into Colombia and other Latin American countries with its modern, self-service retail model. Collectively, these chains are transforming
the region’s pharmacy landscape through a blend of accessibility, innovation, and powerful local identity.
- Boots, dm-drogerie markt, and LloydsPharmacy rank among the most prominent and widely recognized pharmacy chains in Europe. Boots, originally established in the UK and now part of the Walgreens Boots Alliance,
maintains a strong presence throughout the UK and several other European markets. Germany’s dm-drogerie markt stands out as one of the continent’s largest and most trusted drugstore brands, renowned for its broad
range of health, wellness, and beauty products. Also headquartered in the UK, LloydsPharmacy operates thousands of outlets and plays a significant role in both physical and digital pharmacy services.
Other influential names shaping Europe’s pharmacy landscape include Rossmann in Germany, Apoteket AB in Sweden, and CityPharma in Paris—famed among travelers for its extensive product selection and
competitive pricing.
- Pharmacy has a rich and fascinating history filled with surprising facts and milestones. Its origins trace back to ancient Mesopotamia around 2600 BC, where medicinal recipes were etched on clay tablets.
The iconic “Rx” symbol, commonly seen on prescriptions, likely stems from the Latin word recipe meaning “take,” though some believe it has mystical roots in the ancient Egyptian Eye of Horus, a symbol of healing.
In 1886, Coca-Cola was invented by pharmacist John Pemberton as a medicinal tonic containing coca leaves and kola nuts. America’s first hospital pharmacy was established in 1752 at Pennsylvania Hospital in
Philadelphia, with Benjamin Franklin playing a pivotal role. England’s first official drug reference book, the Pharmacopoeia Londinensis, was published in 1618 to standardize apothecary practices. Today,
pharmacists do far more than dispense medication—they administer vaccines, manage chronic conditions, and, in some states, even prescribe treatments, making them vital pillars of modern healthcare.
- Asia is home to some of the most renowned pharmacy and health retail chains, with Watsons leading as the region’s largest, operating over 8,000 stores across 15 markets including China, Hong Kong, Singapore,
Malaysia, Thailand, and the Philippines. Guardian, also known as Mannings in certain regions, is another major chain with more than 1,700 outlets throughout Southeast Asia. In Japan, Tsuruha Drug stands out
with over $9.6 billion in annual sales, making it the top health and pharmaceutical retailer in the Asia-Pacific region as of 2021. Other noteworthy chains include Pharmacity in Vietnam, Kimia Farma and
Apotek K-24 in Indonesia, and Mercury Drug in the Philippines, all of which have established strong national footprints and growing regional influence.
- Japan’s pharmacy landscape is defined by several iconic chains that are celebrated for their accessibility, diverse product offerings, and strong appeal to both locals and visitors.
Matsumoto Kiyoshi—affectionately known as MatsuKiyo—leads the industry with nearly 1,900 stores nationwide, instantly recognizable by its bright yellow signage. Other key players include Tsuruha Drug,
with over 1,000 locations concentrated in northern and eastern Japan; Welcia, renowned for its 24-hour service and comprehensive health and wellness selection; and Sundrug, based in Tokyo, which operates
more than 1,000 outlets across the country. Cocokara Fine, part of the same corporate group as MatsuKiyo, further strengthens Japan’s retail pharmacy network with thousands of additional locations.
For a unique and eclectic shopping experience, Don Quijote—while not a conventional pharmacy—offers a lively pharmacy section within its sprawling discount stores, making it a must-visit for tourists
in search of deals on cosmetics, supplements, and everyday essentials.
- In China, JD Pharmacy, LBX Pharmacy (Laobaixing), and Yifeng Pharmacy stand out as the most prominent and widely recognized pharmacy chains. JD Pharmacy, operated by JD Health, is the country's largest
pharmaceutical retail channel, distinguished by its rapid expansion and seamless integration of e-commerce with healthcare services. Established in 2001, LBX Pharmacy is one of China's leading brick-and-mortar
chains, boasting over 7,000 stores across 22 provinces and offering a diverse mix of Western pharmaceuticals and traditional Chinese medicine. Yifeng Pharmacy, with a strong foothold in eastern and central
regions, is known for its broad product selection and steadily growing retail network. Together, these chains embody China’s dynamic pharmacy landscape, where digital innovation and traditional storefronts
increasingly converge to meet the nation’s rising healthcare needs.
- India’s pharmacy landscape is anchored by several prominent players, with Apollo Pharmacy leading the way through its vast nationwide network and trusted reputation for reliability and product variety.
MedPlus is another major force, combining an extensive chain of physical stores with a strong online presence. PharmEasy, which began as a purely digital platform, has swiftly scaled its footprint by acquiring
offline networks and now operates a hybrid model that blends e-commerce with in-person retail. Other influential brands include Netmeds, Tata 1mg (formerly 1mg), and SastaSundar, each contributing to the
modernization of India’s pharmaceutical industry by integrating traditional drugstore services with digital accessibility. Together, these companies are reshaping healthcare delivery across the country,
making quality medications more accessible, affordable, and consumer-friendly.
- Countries with the largest number of pharmacy stores tend to be those with high populations and strong healthcare infrastructures, with the United States leading globally with over 60,000 community pharmacies,
including major chains like CVS, Walgreens, and Walmart. Japan follows with approximately 50,000 pharmacies, reflecting its commitment to accessible healthcare and preventive services. France and Germany
each host more than 20,000 pharmacies, supported by comprehensive national healthcare systems and strict regulations. Brazil also ranks high, with tens of thousands of pharmacies serving its large and
diverse population across both urban and rural areas.
- Despite having the world’s largest populations, China and India do not have the highest number of pharmacy stores due to a combination of structural, regulatory, and cultural factors. In both countries,
hospitals and clinics often dispense medications directly, reducing reliance on standalone pharmacies. Additionally, physician dispensing is common, especially in rural areas, where doctors both prescribe
and provide medications. Traditional medicine systems like Traditional Chinese Medicine (TCM) and Ayurveda further shape healthcare delivery, often operating outside conventional pharmacy models. Rural regions
also face infrastructure and economic barriers that limit pharmacy density, while in urban areas, the rapid rise of e-pharmacies—particularly in India—has shifted consumer behavior away from brick-and-mortar
stores. As a result, pharmacy access in China and India is shaped more by integrated and alternative healthcare systems than by retail pharmacy expansion.
- Independent pharmacy stores in the U.S. typically generate about $3.4 million in annual revenue, yielding a gross profit of roughly $748,000 before deducting expenses like rent, wages, and insurance.
After accounting for these operational costs, the average net profit ranges between $75,000 and $158,000 per year. Profitability varies widely based on factors such as location, competition, payer mix, and how efficiently
the pharmacy manages inventory and reimbursement rates, with some owners increasing earnings by operating multiple locations while others may struggle to stay afloat in more challenging markets.
- As of 2025, the U.S. states with the fewest number of pharmacies are typically rural and sparsely populated, including Alaska, Montana, North Dakota, South Dakota, and Nebraska. These states not only have
limited pharmacy presence but also some of the highest rates of “pharmacy deserts,” where residents often face long travel distances—sometimes over 30 miles—to access medication. This shortage is largely attributed
to low population density, limited economic incentives for pharmacy operations, and the continued closure of small or independent locations, highlighting a growing disparity in healthcare access across regions.
- As of 2025, California has the largest number of pharmacy locations in the United States, leading with approximately 4,879 Express Scripts sites, 1,067 CVS Pharmacy stores, 504 Health Mart locations, and 257
Good Neighbor Pharmacy outlets. Florida follows closely, notably having around 788 Walgreens locations—the highest number for that chain nationwide. These figures reflect broader trends, with high-population states
like California, Florida, and Texas hosting the most pharmacies due to greater healthcare demand, urban density, and extensive medical infrastructure.
- Two of the oldest pharmacies still operating in the U.S. are Carl’s Drug in Greencastle, Pennsylvania, and C.O. Bigelow in New York City.
- Carl’s Drug (Greencastle, Pennsylvania) - Founded in 1825, Carl’s Drug is the oldest continuously operating drug store in the U.S. It was established
by Adam B. Carl, who originally opened the pharmacy on South Carlisle Street in Greencastle. Over the years, the store moved locations within the borough but remained a staple of the community. The pharmacy has been passed
down through generations and continues to serve customers today.
- C.O. Bigelow (New York City) - Established in 1838, C.O. Bigelow began as The Village Apothecary Shop in Greenwich Village, founded by
Dr. Galen Hunter. In 1880, Clarence Otis Bigelow purchased the store and renamed it after himself. The pharmacy has served many famous customers, including Mark Twain, Eleanor Roosevelt, and Thomas Edison, who reportedly
used Bigelow’s balm to soothe burns while testing his light bulb prototype. The store remains a historic landmark and continues to operate in its original location.
- Santa Maria Novella Pharmacy, The Old Pharmacy, Goldene Apotheke, Adler Pharmacy, and Concordia Pharmacy are the most oldest pharmacies in the world that are still in operation. These pharmacies are not just places
to buy medicine—they are living pieces of history, preserving centuries-old traditions while adapting to modern healthcare needs.
- Santa Maria Novella Pharmacy (Florence, Italy) – Established in 1221, this pharmacy was originally run by Dominican monks who created herbal remedies. It opened to the public in 1612, features 800-year-old recipes,
and still sells traditional products today. Located at Via della Scala, 16, this historic pharmacy is renowned for its beautifully preserved interiors, including frescoed ceilings and antique furnishings.
- The Old Pharmacy (Dubrovnik, Croatia) – Founded in 1317, the Old Pharmacy in Dubrovnik, Croatia, is one of the oldest pharmacies in Europe, dating back to 1317. this pharmacy is located within the Franciscan
Monastery and has been serving the community for centuries. Originally established as an in-house pharmacy for Franciscan friars, it later opened to the public, serving the entire town and beyond. Today, the pharmacy
still operates, offering traditional skincare products made using ancient Franciscan recipes.
- Goldene Apotheke (Trier, Germany) – Dating back to 1241, the Goldene Apotheke in Trier, Germany, is not widely documented under that name, but the Löwen-Apotheke appears to be the oldest pharmacy in Germany,
dating back to 1241. Located at Hauptmarkt 6, in the heart of Trier, and recognized as a cultural landmark, this pharmacy has been a cornerstone of German pharmaceutical history.
- Adler Pharmacy (Lviv, Ukraine) – Established in 1735, the Adler Pharmacy in Lviv, Ukraine, has remained operational and even features a museum showcasing historical pharmaceutical tools. This historic pharmacy
showcases pharmaceutical artifacts in a preserved drugstore setting.
- Concordia Pharmacy (Tallinn, Estonia) – This historic pharmacy is one of the oldest continuously operating pharmacies in Northern Europe, dating back to 1422.
- As of 2025, Americans are projected to spend approximately $635 billion on medications, reflecting a continued rise in pharmaceutical expenditures driven by increased utilization, novel therapies, and chronic disease
management. However, this figure is slightly lower than the $806 billion spent in 2024, according to the American Journal of Health-System Pharmacy. Meanwhile, the U.S. pharmaceutical industry’s revenue is expected to
reach about $662 billion in 2025, with oncology drugs leading the market segment. These figures highlight the immense scale of the pharmaceutical economy and the growing role of innovative treatments in shaping both
spending and revenue trends.
- As of 2025, CVS Health stands as the dominant pharmacy chain in the United States, leading in both workforce size and profitability. With over 300,000 employees across its retail pharmacies, MinuteClinics, and
Aetna insurance division, CVS commands more than 25% of the nation’s prescription drug market and generates the highest revenue among its competitors. Its success is largely attributed to a vertically integrated business
model that unites retail operations, pharmacy benefit management (through Caremark), and health insurance services to optimize efficiency and earnings. While major players like Walgreens Boots Alliance, Cigna
(via Express Scripts), UnitedHealth Group (via Optum Rx), and Walmart also maintain substantial market shares and workforces, CVS consistently outpaces them across key metrics.
- CVS has faced a series of reputation challenges in recent years, ranging from long customer wait times and prescription delays to high employee turnover and walkouts linked to pharmacist burnout and staffing shortages.
It has also come under fire for inflating generic drug prices—sometimes by over 100 times the manufacturer’s cost—raising serious concerns about transparency and affordability. Additionally, billing and insurance processing
issues, as well as employee complaints about toxic work environments and poor corporate support, have contributed to a decline in public and employee trust, even as the company continues expanding its healthcare
services and digital initiatives.
- According to a Wall Street Journal investigation, CVS Health and Cigna charged insurance companies and patients over $6,600 per month for Gleevec prescriptions—despite the drug going generic in 2016 and being
available today for as little as $55 a month—resulting in prices that were more than 100 times higher than manufacturer costs. Across a wider range of specialty generic drugs, CVS and Cigna’s prices averaged at
least 24 times higher than the manufacturers’, while UnitedHealth Group’s prices were approximately 3.5 times as much. These significant markups have drawn criticism for undermining the affordability of generics
and raising concerns about the role of vertically integrated pharmacy benefit managers (PBMs) in inflating medication costs.
- In June 2015, CVS Health acquired Target’s pharmacy and clinic businesses for approximately $1.9 billion, gaining control of 1,672 pharmacies across 47 states that were rebranded as CVS/pharmacy and operated
as “store-within-a-store” locations. The deal also included 79 Target clinics, which were converted into CVS MinuteClinics, with plans to open up to 20 additional clinics within three years. This strategic
acquisition expanded CVS’s retail footprint into new markets such as Seattle, Denver, Portland, and Salt Lake City, bolstering its presence as the nation’s second-largest drugstore chain at the time.
- Pharmacies and drugstores have been around 2100 B.C. and Baghdad was home to some of the earliest
drugstores, dating as far back as the 8th century. Pennsylvania Hospital, which was considered as the first hospital pharmacy in America,
was founded in 1751 by Dr. Thomas Bond and Benjamin Franklin "to care for the sick-poor and insane who were wandering the streets of Philadelphia";
Benjamin Franklin can be considered as a founding father of pharmacy. In America, prior to early 1800s,
a pharmacist did not require to have a license. French immigrant Louis Dufilho Jr. of New Orleans became American’s first licensed pharmacist in 1816, he opened his
pharmacy in the French Quarter in 1823, making medicine and science accessible to a fast-growing city as it battled devastating disease.
- A search conducted by consumerreports.org with participants from 200 pharmacies throughout
the U.S. to get prices on a month’s supply of five generic blockbuster drugs, including Actos (pioglitazone), for diabetes;
Lexapro (escitalopram), an antidepressant;
Lipitor (atorvastatin), for high cholesterol;
Plavix (clopidogrel), a blood thinner; and
Singulair (montelukast), for asthma. As per the result, a whopping difference of 447 percent, between the highest-
and lowest-priced stores. The Costco and Healthwarehouse.com had very low prices, and CVS,
Rite Aid, and Target had the highest retail prices. Costco had the lowest retail prices and
CVS had the highest prices for five widely prescribed generics.
- In the United States, pharmacists and physicians are regulated as separate professions, and strict legal boundaries prevent pharmacists from forming business partnerships with doctors or offering them kickback payments, which would
violate federal anti-kickback laws. This separation is designed to uphold the principle of dispensing independence, ensuring that prescribing and dispensing functions remain distinct to protect patients from conflicts of interest and
promote ethical medical decision-making based solely on clinical need.
- In many Asian countries, especially in parts of East and Southeast Asia, physicians are permitted to both prescribe and dispense medications, a practice known as physician dispensing. This model is common in healthcare systems
where pharmacies are not always separate from clinics or hospitals. In traditional Chinese medicine (TCM), the integration is even more pronounced—practitioners often diagnose, prescribe, and prepare herbal remedies themselves,
blending the roles of doctor and pharmacist into a single practice. This holistic approach is rooted in centuries of tradition and remains prevalent in countries like China, where both modern and traditional pharmacy practices
coexist within the healthcare system.
- According to the World Health Organization, there are indeed an estimated 2.6 million pharmacists and other pharmaceutical personnel globally. This figure includes not only licensed pharmacists but also pharmaceutical technicians
and assistants, reflecting the broad spectrum of professionals involved in medication management, distribution, and patient care across diverse healthcare systems. The number continues to grow as countries expand access to
healthcare and strengthen their pharmaceutical workforce to meet rising demands.
- Several U.S. pharmacy schools consistently produce the largest number of pharmacists each year, led by the University of Florida, which operates one of the country’s biggest Pharm.D. programs through multiple
campuses and a strong online platform. Midwestern University, with campuses in Chicago and Glendale, also graduates a high volume of pharmacy students annually, as does the University of Southern California (USC),
known for its prestigious private program. In Texas, Texas Tech University Health Sciences Center and the University of Houston contribute significantly to the pharmacist workforce, while the University of Mississippi
and the University of Kentucky also rank among the top producers of Pharm.D. graduates. Together, these institutions form a major pipeline for the more than 12,000 pharmacy degrees awarded annually in the U.S.
- As of 2025, the U.S. pharmacist workforce is distributed across several key sectors. Approximately 113,000 pharmacists work in community pharmacy settings, with around 67,000 employed by pharmacy store chains and 46,000
in independent pharmacies. In addition, about 41,000 pharmacists are based in hospitals, where they play increasingly vital roles in clinical care. Another 21,000 pharmacists are employed in government, academic, industry,
and other specialized roles, contributing to research, regulation, education, and pharmaceutical innovation. This distribution reflects the diverse and evolving landscape of pharmacy practice across the country.
- Employment of pharmacists in the U.S. is projected to grow at a moderate pace—about 5% from 2023 to 2033—closely aligning with the average growth rate for all occupations, according to the U.S. Bureau of Labor Statistics.
However, more optimistic forecasts, such as those from the Health Resources and Services Administration (HRSA), suggest that demand could increase by as much as 19% to 29% by 2030. These higher projections take into account
trends like an aging population, expanding clinical responsibilities for pharmacists, and growing access to healthcare services that could drive greater need for pharmacy expertise, particularly in hospital, clinical, and
ambulatory care settings.
- Public trust in healthcare professionals remains high, with nurses leading at 76% of Americans rating their honesty and ethics as “high” or “very high,” followed by pharmacists at 57%, and
medical doctors at 53%, according to Gallup’s 2024 survey. Although these professions continue to be among the most trusted, the ratings for doctors and pharmacists have declined in recent years.
- As of 2025, there are over 313,000 pharmacists employed in the U.S., earning an average annual salary of approximately $151,000. While bonus data isn't consistently reported nationwide, a median bonus of $4,500 is a reasonable
estimate based on industry trends. Pharmacists typically work full-time, and an average of 43 hours per week aligns with standard expectations across various practice settings.
- As of 2025, pharmacist salaries show notable variation by geography and setting. Pharmacists in urban and suburban areas earn approximately $112,000, while those in rural pharmacies make slightly less, around $110,500.
Regionally, salaries range from about $104,000 in the Midwest to $115,500 in the Southwest, with the Northwest, Southeast, and Northeast falling in between. These differences reflect factors like cost of living, demand for
healthcare services, and workforce distribution across the U.S.
- There are approximately 182,000 pharmacy technicians working in retail pharmacies, earning an average annual salary of around $27,000. This widespread availability reflects the relatively low barrier to entry in the field,
which can influence compensation levels. However, wages can vary significantly depending on certification, experience, and geographic location, with urban and hospital settings often offering higher pay. Despite the modest earnings,
retail pharmacy technician roles are vital to healthcare delivery and often serve as stepping stones to more advanced positions, such as supervisory roles, licensed pharmacists, or careers in research and healthcare administration.
- Pharmacists in the U.S. make approximately 150 million clarifying phone calls to physicians each year, with the majority of these calls driven by drug-related concerns such as dosage, interactions, or contraindications.
The remainder typically stems from issues with handwritten prescriptions—including illegibility or missing details—and from prescription changes or rework tied to insurance eligibility, formulary restrictions, and similar
benefits coverage challenges. These communications play a crucial role in ensuring patient safety and navigating the complexities of modern healthcare systems.
- Historically, aspiring pharmacists in the U.S. could pursue either a five-year Bachelor of Science in Pharmacy (BS Pharmacy) or a six-year Doctor of Pharmacy (PharmD). However, a major shift occurred around the year 2000,
when the Accreditation Council for Pharmacy Education (ACPE) implemented new standards that made the PharmD the sole entry-level degree for pharmacists. This change officially took effect on July 1, 2000, and since then,
U.S. pharmacy schools have exclusively offered the PharmD as the standard professional degree.
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